Rapid implant prosthetic heart valve system
A heart valve prosthesis that can be quickly and easily implanted during a surgical procedure is provided. The prosthetic valve has a base stent that is deployed at a treatment site, and a valve component configured to quickly connect to the base stent. The base stent may take the form of a self- or balloon-expandable stent that expands outward against the native valve with or without leaflet excision. The valve component has a non-expandable prosthetic valve and a self- or balloon-expandable coupling stent for attachment to the base stent, thereby fixing the position of the valve component relative to the base stent. The prosthetic valve may be a commercially available to valve with a sewing ring and the coupling stent attaches to the sewing ring. The system is particularly suited for rapid deployment of heart valves in a conventional open-heart surgical environment. A catheter-based system and method for deployment is provided.
1. A prosthetic heart valve and deployment system, comprising:
a delivery handle; and
a hybrid prosthetic heart valve held on a distal end of the delivery handle, the heart valve including:
a non-expandable, non-collapsible valve member having commissures and defining a flow orifice therethrough and valve leaflets configured to permit one-way blood flow through the flow orifice from an inflow end to an outflow end of the valve member, and a sewing ring surrounding the inflow end thereof, and
an expandable coupling stent having a proximal end attached to the inflow end of the valve member, the coupling stent extending away from the valve member in a distal direction and having a free distal end convertible between a contracted state and an expanded state.
2. The system of claim 1 , wherein the coupling stent is plastically expandable and the catheter has a balloon on a distal end thereof configured to convert the coupling stent between the contracted state and the expanded state.
3. The system of claim 1 , wherein the coupling stent is self-expandable.
4. The system of claim 3 , further including a catheter slidable within and relative to the delivery handle and sized to extend through the flow orifice of the valve member, the catheter having a nose cone on a distal end adapted to retain the coupling stent in its contracted state prior to conversion to the expanded state.
5. The system of claim 1 , wherein the coupling stent comprises a plurality of radially expandable struts at least some of which are arranged in rows, and the contracted state of the coupling stent is generally conical, tapering inward in the distal direction.
6. The system of claim 1 , wherein the proximal end of the coupling stent is attached with sutures to the inflow end of the valve member.
7. The system of claim 6 , wherein the valve leaflets are supported by three commissural posts and a ring around the inflow end of the valve member, and the proximal end of the coupling stent is attached with sutures to the ring.
8. The system of claim 1 , wherein the proximal end of the coupling stent includes an interrupted reinforcing ring comprising a series of short lengths separated by gaps.
9. A prosthetic heart valve and deployment system, comprising:
a delivery handle; and
a hybrid prosthetic heart valve held on a distal end of the delivery handle, the heart valve including:
a non-expandable, non-collapsible valve member having commissures and defining a flow orifice therethrough and valve leaflets configured to permit one-way blood flow through the flow orifice from an inflow end to an outflow end of the valve member, and
a self-expandable coupling stent having a proximal end attached to the inflow end of the valve member, the coupling stent extending away from the valve member in a distal direction and having a free distal end convertible between a contracted state and an expanded state; and
a catheter slidable within and relative to the delivery handle and sized to extend through the flow orifice of the valve member, the catheter having a nose cone on a distal end adapted to retain the coupling stent in its contracted state prior to conversion to the expanded state.
10. The system of claim 9 , wherein the coupling stent comprises a plurality of radially expandable struts at least some of which are arranged in rows, and the contracted state of the coupling stent is generally conical, tapering inward in the distal direction.
11. The system of claim 9 , further including a sewing ring surrounding the inflow end of the valve member has an undulating contour and the proximal end of the coupling stent follows an undulating path with alternating arcuate troughs and peaks so as to conform to the undulating contour of the sewing ring.
12. The system of claim 9 , wherein the proximal end of the coupling stent includes an interrupted reinforcing ring comprising a series of short lengths separated by gaps.
13. The system of claim 9 , wherein the proximal end of the coupling stent is attached with sutures to the inflow end of the valve member.
14. The system of claim 13 , wherein the valve leaflets are supported by three commissural posts and a ring around the inflow end of the valve member, and the proximal end of the coupling stent is attached with sutures to the ring.
15. A prosthetic heart valve and deployment system, comprising:
a delivery handle; and
a hybrid prosthetic heart valve held on a distal end of the delivery handle, the heart valve including:
a non-expandable, non-collapsible valve member having commissures and defining a flow orifice therethrough and valve leaflets configured to permit one-way blood flow through the flow orifice from an inflow end to an outflow end of the valve member, and
a self-expandable coupling stent having a proximal end attached to the inflow end of the valve member, the coupling stent extending away from the valve member in a distal direction and having a free inflow end convertible between a contracted state and an expanded state; and
a catheter slidable within and relative to the delivery handle and sized to extend through the flow orifice of the valve member, the catheter being configured to enable conversion of the coupling stent between the contracted state and the expanded state.
16. The system of claim 15 , wherein the coupling stent is plastically expandable and the catheter has a balloon on a distal end thereof configured to convert the coupling stent between the contracted state and the expanded state.
17. The system of claim 15 , wherein the coupling stent is self-expandable.
18. The system of claim 17 , wherein the catheter has a nose cone on a distal end adapted to retain the coupling stent in its contracted state prior to conversion to the expanded state.
19. The system of claim 15 , wherein the proximal end of the coupling stent includes an interrupted reinforcing ring comprising a series of short lengths separated by gaps.
20. The system of claim 15 , wherein the valve leaflets are supported by three commissural posts and a ring around the inflow end of the valve member, and the proximal end of the coupling stent is attached with sutures to the ring.