Two stage anchor and mitral valve assembly
Systems and methods for medical interventional procedures, including approaches to valve implantation. In one aspect, the methods and systems involve a modular approach to mitral valve therapy.
1 . A prosthetic mitral valve system, comprising:
an anchoring structure configured to be received adjacent a native mitral valve, the anchoring structure including a central hub positioned sub-annularly and a plurality of sub-annular projections configured to extend upwardly from the central hub and engage a sub-annular commissural gutter of the native mitral valve, the anchoring structure including a supra-annular structure configured to reside above an annulus of the native mitral valve, the supra-annular structure comprising at least one supra-annular arch segment extending between adjacent sub-annular projections; and
an artificial valve assembly configured to be received by the anchoring structure.
2 . The system of claim 1 , wherein the at least one supra-annular arch segment comprises a plurality of supra-annular arch segments extending between each pair of adjacent sub-annular projections such that the plurality of supra-annular arch segments form a continuous ring-like structure configured to mechanically engage with the valve assembly.
3 . The system of claim 2 , wherein the plurality of supra-annular arch segments are at least partially covered with fabric.
4 . The system of claim 2 , wherein the plurality of supra-annular arch segments comprises three supra-annular arch segments.
5 . The system of claim 1 , wherein the at least one supra-annular arch segment comprises at least a pair of adjacent supra-annular arch segments and the supra-annular structure further comprises a bridge support extending between the pair of adjacent supra-annular arch segments.
6 . The system of claim 1 , wherein the anchoring structure includes an anti-SAM component.
7 . The system of claim 1 , wherein the artificial valve assembly comprises:
an external outer surface configured to mechanically engage within an internal space defined by the anchoring structure; and
an annulus passageway smaller in diameter than the outer surface.
8 . The system of claim 1 , wherein the artificial valve assembly comprises an expandable frame with a stent structure having an inferior end and a superior end, the inferior end having a non-circular axial opening larger than a circular axial opening in the superior end.
9 . The system of claim 8 , wherein the artificial valve assembly comprises:
three arches disposed at the superior end of the expandable frame, each arch having an apex at the superior end and a base closer to the inferior end than the apex, and adjacent arches connected at their bases to define a parabolic profile between arches;
three posts attached to each base respectively and extending in an inferior direction; and
tissue attached to the three arches and three posts to define three leaflets of the prosthetic valve assembly.
10 . The system of claim 1 , wherein the anchoring structure includes an anti-SAM component at least partially covered by a fabric and including a portion for abutting a natural anterior leaflet to prevent the natural anterior leaflet from obstructing an aortic outflow tract.
11 . A prosthetic mitral valve system comprising:
an anchoring structure configured to be received adjacent a native mitral valve, the anchoring structure including at least one sub-annular projection configured to engage a sub-annular gutter of the native mitral valve to position the anchoring structure relative to the native mitral valve, the anchoring structure including a supra-annular structure configured to reside above an annulus of the native mitral valve, the supra-annular structure comprising at least one supra-annular arch segment extending upwardly from the at least one sub-annular projection, the at least one supra-annular arch segment extending between a first end and a second end, and the supra-annular structure comprises at least one stabilization frame positioned adjacent the at least one supra-annular arch segment, the at least one stabilization frame extending between the first end and second end, and wherein a terminal end of the supra-annular arch segment is completely axially offset from the sub-annular projection.
12 . The system of claim 11 , wherein the at least one sub-annular projection comprises at least one pair of adjacent sub-annular projections, and the at least one supra-annular arch segment is extending between the at least one pair of adjacent sub-annular projections such that the at least one supra-annular arch segment forms a continuous ring-like structure configured to mechanically engage with a prosthetic valve assembly.
13 . The system of claim 11 , wherein the anchoring structure includes an anti-SAM component.
14 . The system of claim 12 , wherein the at least one supra-annular arch segment comprises at least one pair of supra-annular arch segments, and the supra-annular structure further comprises a bridge support extending between the at least one pair of adjacent supra-annular arch segments.
15 . The system of claim 11 , wherein the anchoring structure includes a central hub.
16 . The system of claim 11 , further comprising a prosthetic valve assembly, comprising:
an external outer surface configured to mechanically engage within an internal space defined by the anchoring structure; and
an annulus passageway smaller in diameter than the outer surface.
17 . The system of claim 11 , further comprising a prosthetic valve assembly configured to be positioned within an internal space defined by the anchoring structure, the prosthetic valve assembly comprising:
an expandable frame with a stent structure having an inferior end and a superior end, the inferior end having a non-circular axial opening larger than a circular axial opening in the superior end;
three arches disposed at the superior end of the expandable frame, each arch having an apex at the superior end and a base closer to the inferior end than the apex, and adjacent arches connected at their bases to define a parabolic profile between the arches;
three posts attached to each base respectively and extending in an inferior direction; and
tissue attached to the three arches and three posts to define three leaflets of the prosthetic valve assembly.
18 . A prosthetic mitral valve system, comprising:
an anchoring structure configured to be received adjacent a native mitral valve, the anchoring structure including sub-annular projections and a central hub, the sub-annular projections configured to engage a sub-annular commissural gutter of the native mitral valve, the anchoring structure including a supra-annular structure configured to reside above an annulus of the native mitral valve, the supra-annular structure comprising at least one supra-annular arch segment extending between adjacent sub-annular projections;
a prosthetic valve assembly to be received by the anchor assembly, comprising:
a valve frame configured to be received adjacent the native mitral valve and completely above a bottom extent of the anchoring structure, the valve frame including valve frame sub-annular projections configured to engage the sub-annular commissural gutter of the native mitral valve, the valve frame comprising at least one valve frame supra-annular arch segment extending between adjacent valve frame sub-annular projections; and
an artificial valve assembly configured to be received by the valve frame.
19 . The prosthetic mitral valve system of claim 18 , further comprising:
a deployment system comprising multiple catheters configured to deliver the prosthetic mitral valve system, wherein at least some of the catheters are slidably engageable with each other and are releasably coupleable to the prosthetic mitral valve system.
20 . The prosthetic mitral valve system of claim 18 , wherein the valve frame comprises a plurality of cells including a first cell and a second cell larger than the first cell.
21 . The system of claim 11 , wherein the at least one stabilization frame is radially offset from the sub-annular projection.
22 . The system of claim 18 , wherein the central hub is positioned about a central axis of the anchoring frame, and the valve frame is configured to be received completely above a bottom extent of the central hub.
23 . A prosthetic mitral valve system comprising:
an anchoring structure configured to be received adjacent a native mitral valve, the anchoring structure including at least one sub-annular projection configured to engage a sub-annular gutter of the native mitral valve to position the anchoring structure relative to the native mitral valve, the anchoring structure including a supra-annular structure configured to reside above an annulus of the native mitral valve, the supra-annular structure comprising at least one supra-annular arch segment extending upwardly from the at least one sub-annular projection, the at least one supra-annular arch segment extending between a first end and a second end, and the supra-annular structure comprises at least one stabilization frame positioned adjacent the at least one supra-annular arch segment, the at least one stabilization frame extending between the first end and second end, and wherein the at least one stabilization frame is radially offset from the sub-annular projection.