Device and method with reduced pacemaker rate in heart valve replacement
The disclosure relates to heart valve prostheses with the reduced need of pacemaker implantation and improved means for positioning the replacement heart valve. In one aspect of the present disclosure, the stent scaffold of the valve prosthesis includes axially extending locators. The locators may be positioned within the cusp of the native aortic valve. Placement of the locators within the cusps may prevent further proximal movement of the stent scaffold into the left ventricle. By adjusting the location of the proximal end of the locators with respect to the proximal end of the stent scaffold, infra-annular placement of the stent scaffold in the aortic annulus may be assured. In another aspect, means for visualizing the positioning of replacement heart valves at an implant site inside an individual's body is disclosed.
1. A heart valve prosthesis for implantation at a native valve site, the heart valve prosthesis comprising:
a ring of cells disposed at a proximal end of the heart valve prosthesis;
a stent comprising a plurality of interconnected cells defining a plurality of stent arches at a distal end of the heart valve prosthesis, the interconnected cells extending from the plurality of stent arches to the ring of cells;
a plurality of locators, each locator coupled to at least one stent arch of the plurality of stent arches and configured to extend radially with respect to the stent to capture at least a portion of a respective native leaflet at the native valve site between such locator and the stent;
a stent cover coupled to the stent and covering at least a portion of the stent, the stent cover comprising a prosthetic valve; and
a plurality of locator covers separate from the stent cover, each locator cover coupled to and completely covering an end of a respective locator of the plurality of locators, the plurality of locator covers each configured to contact the respective native leaflet,
wherein the stent cover and the stent are configured to form a seal between the heart valve prosthesis and a native valve site valve to prevent blood flow between the heart valve prosthesis and the native valve site, and
wherein the stent cover and the stent are configured to permit blood flow to at least one coronary artery at the native valve site.
2. The heart valve prosthesis of claim 1 , wherein a first stent arch of the plurality of stent arches is coupled to a second stent arch of the plurality of stent arches and a first apex of the first stent arch and second apex of the second stent arch are spaced a certain distance apart to permit blood flow to the at least one coronary artery.
3. The heart valve prosthesis of claim 2 , wherein the first apex of the first stent arch and the second apex of the second stent arch are freestanding and facilitate unobstructed blood flow to the at least one coronary artery.
4. The heart valve prosthesis of claim 1 , wherein each locator of the plurality of locators comprises a locator arch with a first end and a second end, the first end and the second end each coupled to a respective stent arch of the plurality of stent arches.
5. The heart valve prosthesis of claim 4 , wherein each stent arch of the plurality of stent arches comprises a first apex in a distal direction and each locator arch plurality of locator arches comprises a second apex in a proximal direction.
6. The heart valve prosthesis of claim 4 , wherein each locator of the plurality of locators comprises at least one radiopaque marker disposed on an apex of each respective locator arch.
7. The heart valve prosthesis of claim 1 , wherein each locator of the plurality of locators comprises at least one radiopaque marker.
8. The heart valve prosthesis of claim 1 , wherein each locator cover of the plurality of locator covers comprises a biological material, the biological material configured to facilitate biocompatibility with tissue of the respective native leaflet.
9. The heart valve prosthesis of claim 1 , wherein each locator cover of the plurality of locator covers comprises a coating covering at least a portion of each locator of the plurality of locators.
10. The heart valve prosthesis of claim 9 , wherein the coating covers an end portion of each locator of the plurality of locators.
11. The heart valve prosthesis of claim 1 , wherein the stent cover is a biological material, the biological material configured to facilitate biocompatibility with tissue of the native valve site.
12. A heart valve prosthesis for implantation at a native valve site, the heart valve prosthesis comprising:
a ring of cells disposed at a proximal end of the heart valve prosthesis;
a stent comprising a plurality of interconnected cells defining a plurality of stent arches at a distal end of the heart valve prosthesis, the interconnected cells extending from the plurality of stent arches to the ring of cells;
a plurality of locators, each locator coupled to the stent and configured to extend radially with respect to the stent when the stent is in a compressed state to capture at least a portion of a respective native leaflet at the native valve site between such locator and the stent;
a stent cover coupled to the stent and covering at least a portion of the stent, the stent cover comprising a prosthetic valve; and
a plurality of locator covers separate from the stent cover, each locator cover coupled to and completely covering an end of a respective locator of the plurality of locators, the plurality of locator covers each configured to contact a respective native leaflet,
wherein a first stent arch of the plurality of stent arches is coupled to a second stent arch of the plurality of stent arches and a first apex of the first stent arch and a second apex of the second stent arch are spaced a certain distance apart such that the first stent arch and the second stent arch permit blood flow to at least one coronary artery at the native valve site.
13. The heart valve prosthesis of claim 12 , wherein the stent cover and the stent form a seal between the heart valve prosthesis and the native valve site to prevent blood flow between the heart valve prosthesis and the native valve site.
14. The heart valve prosthesis of claim 12 , wherein each locator of the plurality of locators comprises a locator arch with a first end and a second end, the first end and the second end each coupled to a respective stent arch of the plurality of stent arches.
15. The heart valve prosthesis of claim 14 , wherein each stent arch of the plurality of stent arches comprises a first apex in a distal direction and each locator arch of the plurality of locator arches comprises a second apex in a proximal direction.
16. The heart valve prosthesis of claim 14 , wherein each locator of the plurality of locators comprises at least one radiopaque marker disposed on an apex of each respective locator arch.
17. The heart valve prosthesis of claim 12 , wherein each locator of the plurality of locators comprises at least one radiopaque marker.
18. The heart valve prosthesis of claim 12 , wherein each locator cover of the plurality of locator covers comprises a biological material, the biological material configured to facilitate biocompatibility with tissue of the respective native leaflet.
19. The heart valve prosthesis of claim 12 , wherein each locator cover of the plurality of locator covers comprises a coating covering at least a portion of each locator of the plurality of locators.
20. The heart valve prosthesis of claim 19 , wherein the coating covers an end portion of each locator of the plurality of locators.
21. The heart valve prosthesis of claim 12 , wherein the first apex of the first stent arch and the second apex of the second stent arch are freestanding and facilitate unobstructed blood flow to the at least one coronary artery.