Sinus-engaging valve fixation member
A prosthesis is provided for implantation at a native semilunar valve of a native valve complex, the native valve complex having three semilunar sinuses and three native commissures. The prosthesis includes a valve prosthesis support, which comprises a support structure comprising exactly three engagement arms that meet one another at three respective junctures. The engagement arms are shaped so as define three peak complexes at the three respective junctures, and three trough complexes, each of which is between two of the peak complexes. Upon implantation of the prosthesis, each of the engagement arms is at least partially disposed within a respective one of the semilunar sinuses, such that each of the peak complexes is disposed distal to and in rotational alignment with a respective one of the native commissures, and each of the trough complexes is disposed at least partially within the respective one of the semilunar sinuses.
1. A valve prosthesis comprising:
an expandable annular support structure including:
an inflow portion having an inflow end and a distal end, the inflow portion including at least three rows of angled struts disposed between the inflow end and the distal end; and
a plurality of commissure posts each having a proximal end terminating at the distal end of the inflow portion and extending distally therefrom, each of the commissure posts including an elongated slit; and
a valve member positioned inside the annular support structure and attached to the commissure posts, the valve member including a plurality of leaflets.
2. The valve prosthesis of claim 1 , wherein each of the plurality of leaflets includes opposing side ends, each of the opposing side ends being paired with an adjacent side end of an adjacent leaflet to form commissures, and
wherein each commissure extends radially outward through the elongated slit of a corresponding commissure post of the plurality of commissure posts.
3. The valve prosthesis of claim 2 , wherein each commissure is sutured to the corresponding commissure post.
4. The valve prosthesis of claim 1 , further comprising a covering extending through the elongated slit of the corresponding commissure post between edges of the slit and each leaflet of the commissure.
5. The valve prosthesis of claim 4 , wherein the covering is a synthetic material.
6. The valve prosthesis of claim 1 ,
wherein the plurality of commissure posts comprises three commissure posts and the plurality of leaflets comprises three leaflets,
wherein a first leaflet of the three leaflets includes a first end and a second end, a second leaflet of the three leaflets includes a includes a first end and a second end, and a third leaflet of the three leaflets includes a includes a first end and a second end,
wherein the second end of the first leaflet and the first end of the second leaflet form a first commissure, the second end of the second leaflet and the first end of the third leaflet form a second commissure, and the second end of the third leaflet and the first end of the first leaflet for a third commissure, and
wherein the first commissure extends radially outward through the elongated slit of a first commissure post of the three commissure posts, the second commissure extends radially outward through the elongated slit of a second commissure posts of the three commissure posts, and the third commissure extend radially outward through the elongated slit of a third commissure post of the three commissure posts.
7. The valve prosthesis of claim 6 , wherein the first commissure is sutured to the first commissure post, the second commissure is sutured to the second commissure post, and the third commissure is sutured to the third commissure post.
8. The valve prosthesis of claim 6 , wherein the inflow portion comprises a bulging proximal skirt.
9. A valve prosthesis comprising:
an expandable annular support structure including an inflow portion including a plurality of rows of angled struts, and a plurality of commissure posts each having a proximal end terminating at a distal end of the inflow portion and extending distally therefrom;
a valve member positioned inside the annular support structure and attached to the plurality of commissure posts, the valve member including a plurality of leaflets; and
a covering coupled to an interior of the inflow portion of the annular support structure,
wherein the leaflets are attached to the covering.
10. The valve prosthesis of claim 9 , wherein the leaflets are attached to the covering along a joint line, and wherein the joint line is mostly unsupported by the inflow portion of the annular support structure.
11. The valve prosthesis of claim 9 , further comprising a reinforcing member attached to the covering and the leaflets where the leaflets are attached to the covering.
12. The valve prosthesis of claim 11 , wherein the reinforcing member is a cord.
13. The valve prosthesis of claim 11 , wherein a portion of the leaflets is held between the reinforcing member and the covering.
14. A valve prosthesis comprising:
an expandable annular support structure including an inflow portion including a plurality of rows of angled struts, and a plurality of commissure posts each having a proximal end terminating at a distal end of the inflow portion and extending distally therefrom;
a valve member positioned inside the annular support structure and attached to the plurality of commissure posts, the valve member including a plurality of leaflets;
a covering coupled to an interior of the inflow portion of the annular support structure and coupled to the plurality of leaflets; and
means for reducing stress on the plurality of leaflets.
15. The valve prosthesis of claim 14 , wherein the means for reducing stress on the plurality of leaflets comprises lateral ends of adjacent leaflets supported at inner and outer surfaces thereof at the commissures.
16. The valve prosthesis of claim 14 , wherein each of the plurality of commissure posts includes an elongated, longitudinal slit, wherein laterals ends of adjacent leaflets extend through a respective one of the commissure posts and are coupled to the commissure posts.
17. The valve prosthesis of claim 16 , further comprising an outer support, wherein the lateral ends of the adjacent leaflets are coupled between the outer support and the respective commissure posts, thereby forming a strain relief and reducing stresses on the leaflets.
18. The valve prosthesis of claim 14 , wherein the means for reducing stress on the plurality of leaflets comprises a reinforcing member attached to the covering and the leaflets where the leaflets are attached to the covering.
19. The valve prosthesis of claim 18 , wherein the reinforcing member is a cord.