Prosthetic heart valve devices and associated systems and methods
Prosthetic heart valve devices for percutaneous replacement of native heart valves and associated systems and method are disclosed herein. A prosthetic heart valve device configured in accordance with a particular embodiment of the present technology can include an expandable support having an outer surface and configured for placement between leaflets of the native valve. The device can also include a plurality of asymmetrically arranged arms coupled to the expandable support and configured to receive the leaflets of the native valve between the arms and the outer surface. In some embodiments, the arms can include tip portions for engaging a subannular surface of the native valve.
1. A method for treating a native mitral valve having a native mitral valve annulus and native leaflets, the method comprising:
positioning a downstream end of an expandable frame of a prosthetic heart valve apparatus in a low-profile configuration toward a left ventricle and an upstream end of the expandable frame toward a left atrium, wherein the prosthetic heart valve apparatus comprises:
the expandable frame, wherein the expandable frame comprises:
a first portion having a downstream region and an upstream region; and
a second portion extending in an upstream direction from the downstream region;
a valve member mounted to an interior of the first portion of the expandable frame and configured to allow blood flow in the downstream direction and to block blood flow in the upstream direction,
a skirt coupled to the downstream region of the first portion and flaring outward in an upstream direction separate from the second portion, wherein the skirt extends around an entire circumference of the expandable frame, wherein, when the downstream end of the expandable frame is positioned toward the left ventricle and the upstream end of the expandable frame is positioned toward the left atrium, the second portion is positioned inward of an inner surface of native leaflets; and
expanding the prosthetic heart valve apparatus from the low-profile configuration to an expanded configuration at the native mitral valve annulus such that the second portion exerts a force against the inner surface of the native leaflets and an upstream end of the skirt is spaced outwardly from the first portion.
2. The method of claim 1 , wherein when the prosthetic heart valve apparatus is in the expanded configuration, the skirt is inward of the second portion of the expandable frame.
3. The method of claim 1 , wherein the valve member comprises a tri-leaflet assembly.
4. The method of claim 1 , wherein the valve member comprises a bi-leaflet assembly.
5. The method of claim 1 , wherein the first portion of the expandable frame is substantially cylindrical.
6. The method of claim 1 , wherein the second portion of the expandable frame comprises an anchoring portion.
7. The method of claim 6 , wherein the anchoring portion comprises a plurality of elongated members.
8. The method of claim 1 , wherein the expandable frame further comprises a third portion configured to extend outwardly from the upstream region of the first portion in a downstream direction when the expandable frame is in the expanded configuration.
9. The method of claim 1 , wherein the expandable frame further comprises elongated members configured to extend outwardly from the upstream region of the first portion in a downstream direction when the expandable frame is in the expanded configuration.
10. The method of claim 1 , wherein the second portion of the expandable frame is biased outwardly form the first portion of the expandable frame.
11. The method of claim 1 , wherein the skirt is configured to inhibit blood flow between the prosthetic heart valve apparatus and the native mitral valve upon implantation of the prosthetic heart valve apparatus at the native mitral valve.
12. The method of claim 1 , wherein the prosthetic heart valve apparatus further comprises a covering attached to the expandable frame.
13. The method of claim 1 , wherein the first portion of the expandable frame comprises a plurality of interconnected struts.
14. The method of claim 1 , wherein, in the expanded configuration, the second portion has a kidney shape to substantially conform to the native mitral valve annulus.
15. The method of claim 1 , wherein the prosthetic heart valve apparatus further comprises at least one wire coupled to the skirt and configured to maintain a shape of the skirt.
16. The method of claim 1 , wherein the second portion of the expandable frame comprises tissue penetrating elements.
17. The method of claim 1 , wherein the skirt is configured to be inflated with blood to urge the skirt against native tissue at or below the native mitral valve annulus.
18. The method of claim 1 , wherein the prosthetic heart valve apparatus further comprises retention structure coupled to the upstream region of the first portion of the expandable frame, wherein the retention structure is configured to engage tissue on an upstream side of the native mitral valve annulus, and wherein the retention structure comprises a plurality of fingers extending radially outward from the expandable frame.
19. The method of claim 18 , wherein, in the expanded configuration, the retention structure is axially spaced apart from the second portion of the expandable frame and configured to compress the native mitral valve annulus between the retention structure and the second portion of the expandable frame.