Prosthetic valve with natural blood flow
A prosthetic valve may be formed to direct flow out of the outflow orifice toward a posterior portion of a heart wall. The prosthetic valve includes an expandable frame which may be covered with a cover that is suturelessly attached to the frame. The prosthetic valve may also include an outflow orifice size which is controlled. Methods of using these devices are also disclosed.
1. A prosthetic valve configured to be disposed in a native valve of a patient, the native valve lying an anatomic plane, said prosthetic valve comprising:
a radially expandable frame having an expanded configuration and a collapsed configuration, the expanded configuration configured to engage tissue in the native valve, the collapsed configuration configured for delivery to the native valve, the frame further comprising a first end, a second end opposite the first end, an atrial flange adjacent the first end, a ventricular skirt adjacent the second end, a longitudinal axis extending between the first and second ends, an annular region disposed between the atrial flange and the ventricular skirt, and a prosthetic valve mechanism coupled to the radially expandable frame, the prosthetic valve mechanism having an outflow orifice adjacent the second end;
wherein the atrial flange comprises a D-shaped perimeter having a straight portion and a curved portion connected to opposite ends of the straight portion;
wherein the outflow orifice has a fluid flow axis extending therethrough that is disposed at an angle relative to the longitudinal axis such that the outflow orifice faces away from a side of the atrial flange defining the straight portion, or
wherein the atrial flange lies in a plane that is transverse to the longitudinal axis such that the outflow orifice faces away from a side of the atrial flange defining the straight portion;
wherein the prosthetic valve mechanism comprises a plurality of prosthetic valve leaflets and a plurality of commissure posts having a free end and an opposite end coupled to the radially expandable frame, wherein the plurality of prosthetic valve leaflets are coupled to the plurality of commissure posts, and wherein the free ends of the plurality of commissure posts are angled radially inward to form the outflow orifice and the outflow orifice has a diameter less than a diameter of the ventricular skirt.
2. The valve of claim 1 , wherein posterior and anterior sides of the radially expandable frame are curved in the expanded configuration such that the fluid flow axis is curved relative to the longitudinal axis.
3. The valve of claim 1 , wherein posterior and anterior sides of the radially expandable frame are straight in the expanded configuration such that the fluid flow axis is transverse to the longitudinal axis.
4. The valve of claim 1 , wherein the atrial flange plane is non-parallel with the anatomic plane.
5. The valve of claim 1 , wherein the atrial flange plane is transverse to the anatomic plane.
6. The valve of claim 1 , wherein the atrial flange plane is transverse to the longitudinal axis.
7. The valve of claim 1 , wherein the outflow orifice is angled so as to direct fluid flow passing therethrough toward the posterior portion of the patient's heart.
8. The valve of claim 1 , wherein the outflow orifice directs fluid exiting the outflow orifice downstream along a posterior wall of the patient's heart, around an apex of the patient's heart and out a left ventricular outflow tract of the patient's heart.
9. The valve of claim 1 , wherein the fluid flow axis is tilted toward a posterior portion of the patient's heart.
10. The valve of claim 1 , wherein the outflow orifice faces a posterior portion of the patient's heart.
11. The valve of claim 1 , wherein the prosthetic valve mechanism comprises a plurality of prosthetic valve leaflets coupled to the valve structure, wherein at least one of the plurality of prosthetic valve leaflets has an upstream edge and a downstream edge, wherein the upstream edge is disposed more anteriorly relative to the downstream edge, the downstream edge disposed more posteriorly relative to the upstream edge thereby disposing the at least one of the plurality of prosthetic valve leaflets at an angle transverse to the longitudinal axis of the radially expandable frame that directs blood flow towards a posterior portion of the patient's heart.
12. The valve of claim 11 , wherein the plurality of prosthetic valve leaflets consist of two prosthetic valve leaflets.
13. A method for deploying a prosthetic valve in a heart of a patient, said method comprising:
providing a prosthetic valve having a radially expandable frame with an atrial flange adjacent one end, a prosthetic valve mechanism having an outflow orifice and a ventricular skirt adjacent a second end opposite the first end, the atrial flange comprising a D-shaped perimeter having a straight portion and a curved portion connected to opposite ends of the straight portion, the prosthetic valve mechanism comprising a plurality of prosthetic valve leaflets and a plurality of commissure posts having a free end and an opposite end coupled to the expandable frame, wherein the plurality of prosthetic valve leaflets are coupled to the plurality of commissure posts, and wherein the free ends of the plurality of commissure posts are angled radially inward to form an outflow orifice having a diameter less than a diameter of the ventricular skirt;
radially expanding the frame into engagement with a native valve in the heart of the patient to form an annular region; and
directing fluid flow through the prosthetic valve mechanism and out the outflow orifice toward a posterior portion of the patient's heart and away from a side of the atrial flange defining the straight portion.
14. The method of claim 13 , wherein directing the fluid flow comprises directing the fluid flow along a path transverse to a longitudinal axis of the prosthetic valve.
15. The method of claim 13 , wherein directing the fluid flow comprises directing the fluid flow along a path that is non-parallel to a longitudinal axis of the prosthetic valve.
16. A prosthetic valve configured to be disposed in a native valve of a patient, said prosthetic valve comprising:
a radially expandable frame having an expanded configuration to engage tissue in the native valve and a collapsed configuration for delivery to the native valve, the frame comprising a first end, a second end opposite the first end, an atrial flange adjacent the first end, a ventricular skirt adjacent the second end, an annular region disposed between the atrial flange and the ventricular skirt, and a prosthetic valve mechanism for controlling fluid flow therethrough, wherein the prosthetic valve mechanism comprises:
a plurality of prosthetic valve leaflets and a plurality of commissure posts having a free end and an opposite end coupled to the expandable frame, wherein the plurality of prosthetic valve leaflets are coupled to the plurality of commissure posts, and wherein the free ends of the plurality of commissure posts are angled radially inward to form an outflow orifice having a diameter less than a diameter of the ventricular skirt;
wherein:
the atrial flange comprises a D-shaped perimeter having a straight portion and a curved portion connected to opposite ends of the straight portion; and
the annular region comprises an outflow orifice that faces away from a side of the atrial flange defining the straight portion.
17. The valve of claim 16 , further comprising a cover disposed over at least a portion of the frame, the cover welded thereto.
18. The valve of claim 17 , wherein the cover is attached to the frame without sutures.
19. The valve of claim 17 , wherein the cover comprises a fabric, tissue, a polymer, or combinations thereof.