Prosthetic heart valve having multi-level sealing member
Embodiments of a prosthetic heart valve are disclosed. An implantable prosthetic valve may be radially collapsible to a collapsed configuration and radially expandable to an expanded configuration. The prosthetic valve may comprise an annular frame, a leaflet structure positioned within the frame and a plurality of outer skirts positioned around an outer surface of the frame, each outer skirt comprising an inflow edge secured to the frame and an outflow edge secured at intervals to the frame. The plurality of outer skirts may include a first outer skirt and a second outer skirt, wherein in the expanded configuration the first and second outer skirts include openings unsecured to the frame between the intervals. The inflow edge of the first annular outer skirt may be secured to the frame with sutures including radiopaque material. The first annular outer skirt may include radiopaque dye.
1. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy, and wherein the radiopaque marking formed by the radiopaque sutures are in the form of vertical lines.
2. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations and one or more additional radiopaque sutures connecting an upper edge of the outer skirt to the frame;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy.
3. The prosthetic valve of claim 1 , further comprising one or more additional radiopaque sutures connecting a lower edge of the outer skirt to the frame.
4. The prosthetic valve of claim 1 , further comprising one or more additional radiopaque sutures wrapped around struts of the frame at an inflow end of the frame.
5. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations and one or more additional radiopaque sutures wrapped around struts of the frame at an outflow end of the frame;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy.
6. The prosthetic valve of claim 2 , wherein the radiopaque markings formed by the radiopaque sutures are in the form of vertical lines.
7. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy, and
wherein the radiopaque markings formed by the radiopaque sutures are in the form of arrows.
8. The prosthetic valve of claim 1 , wherein the radiopaque sutures comprise radiopaque material extending along a length of the one or more radiopaque sutures.
9. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy, and
wherein the radiopaque material is in the form of a coating extending along the length of the sutures.
10. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure disposed within the frame and coupled to the frame; and
an outer skirt positioned around an outer surface of the frame; and
a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations;
wherein the radiopaque sutures are positioned to indicate an orientation of the prosthetic valve relative to a delivery apparatus and a native heart valve under fluoroscopy, and
wherein the radiopaque material is in form of markings extending along the length of the sutures.
11. An implantable prosthetic valve, comprising:
a radially expandable and compressible annular frame;
a valvular structure comprising a plurality of leaflets disposed within the frame; and
a sealing member disposed on and extending continuously around an outer circumference of the frame, the sealing member comprising an inflow edge coupled to the frame via one or more radiopaque sutures;
wherein the sealing member comprises radiopaque markings, separate from the radiopaque sutures, configured to indicate the orientation of the frame.
12. The prosthetic valve of claim 11 , wherein the sealing member comprises an outflow edge coupled to the frame via one or more additional radiopaque sutures.
13. The prosthetic valve of claim 11 , further comprising one or more additional radiopaque sutures coupled to an inflow end of the frame.
14. The prosthetic valve of claim 11 , further comprising one or more additional radiopaque sutures coupled to an outflow end of the frame.
15. The prosthetic valve of claim 11 , wherein the radiopaque sutures comprise radiopaque material extending along a length of the one or more radiopaque sutures.
16. The prosthetic valve of claim 11 , wherein the markings comprise a plurality of vertical lines.
17. The prosthetic valve of claim 11 , wherein the radiopaque markings comprise additional radiopaque sutures stitched to the sealing member.
18. A method, comprising:
inserting a delivery apparatus into the vasculature of a patient, the delivery apparatus coupled to an implantable prosthetic valve comprising a radially expandable and compressible annular frame, a valvular structure disposed within the frame, an outer skirt positioned around and coupled to an outer surface of the frame, a plurality of radiopaque sutures forming a plurality of discrete radiopaque markings arranged on the outer skirt at a plurality of circumferentially spaced locations, and one or more additional radiopaque sutures connecting an upper edge of the outer skirt to the frame;
advancing the prosthetic valve to a selected implantation site;
determining, using fluoroscopy, the position of the radiopaque markings relative to the implantation site to determine the orientation of the prosthetic valve relative to the implantation site; and
radially expanding the prosthetic valve to a radially expanded configuration.