Prosthetic heart valve
Described herein are prosthetic heart valves and methods for improving the functionality of native heart valves. An exemplary prosthetic heart valve may include one or more support structures, in which at least one support structure defines an elongate central passageway having a longitudinal. The prosthetic heart valve may include a plurality of leaflet elements attached to the at least one support structure and disposed within the elongate central passageway for control of blood flow through the elongate central passageway. The at least one support structure may be configured to biodynamically fix the prosthetic heart valve to native leaflets of a native heart valve of a heart.
1 . A prosthetic heart valve, comprising:
a support structure, wherein the support structure defines an elongate central passageway, wherein the support structure comprises one or more atrial arms, one or more ventricular arms, and a third set of arms;
a plurality of leaflet elements attached to the support structure and disposed within the elongate central passageway for control of blood flow through the elongate central passageway;
a cover formed separately from the support structure and supported by the third set of arms, the cover configured to contact a native leaflet of a native heart valve of a heart and reduce leakage around the prosthetic heart valve,
wherein the support structure is configured to biodynamically fix the prosthetic heart valve to the native leaflet of the native heart valve of the heart and is not fixed to a native annulus of the native heart valve of the heart,
wherein the one or more atrial arms and the one or more ventricular arms extend across a cross-sectional plane of a cylindrical portion of the support structure such that:
a distal segment of the one or more atrial arms and a distal segment of the one or more ventricular arms extend perpendicularly away from a central axis of the elongate central passageway and contact opposing sides of each native leaflet at locations radially inward from the native annulus such that at least a portion of each native leaflet is held radially away from the native annulus thereby permitting axial motion of the cylindrical portion of the support structure and the portion of each native leaflet, relative to the native annulus, and
wherein, during biodynamic movement of the prosthetic heart valve within the native heart valve during cardiac cycles of the heart, the ventricular arms are configured to resist the movement while the atrial arms maintain contact with native leaflets and/or the atrial arms resist the movement while the ventricular arms maintain contact with the native leaflets, such that systolic and/or diastolic pressure load is at least partially absorbed by the motion of the native leaflets.
2 . The prosthetic heart valve of claim 1 , wherein:
the at least one support structure comprises a cylindrical portion comprising an atrial end and a ventricular end, and
the elongate central passageway is defined by the cylindrical portion of the at least one support structure.
3 . The prosthetic heart valve of claim 2 , wherein:
each arm of the one or more atrial arms comprises a proximal atrial segment that is proximal to the cylindrical portion and a distal atrial segment that is distal to the cylindrical portion, and
at least one of a size, a shape, or an angle of a first atrial arm of the one or more atrial arms is different from a corresponding one of a size, a shape, or an angle of a second atrial arm of the one or more atrial arms.
4 . The prosthetic heart valve of claim 3 , wherein the size of the first atrial arm is greater than the size of the second atrial arm.
5 . The prosthetic heart valve of claim 3 , wherein:
the first atrial arm has a first length in a direction parallel to a longitudinal axis and the second atrial arm has a second length in the direction parallel to the longitudinal axis, and
the first length is greater than the second length.
6 . The prosthetic heart valve of claim 5 , wherein the first length is greater than the second length when the prosthetic heart valve is implanted in the heart.
7 . The prosthetic heart valve of claim 5 , wherein:
each arm of the one or more ventricular arms comprises a proximal ventricular segment that is proximal to the cylindrical portion and a distal ventricular segment that is distal to the cylindrical portion, and
at least one of a size, a shape, or an angle of a first ventricular arm is different from a corresponding one of a size, a shape, or an angle of a second ventricular arm.
8 . The prosthetic heart valve of claim 7 , wherein the size of the first ventricular arm is greater than the size of the second ventricular arm.
9 . The prosthetic heart valve of claim 7 , wherein:
the first ventricular arm has a first length in a direction parallel to the longitudinal axis and the second ventricular arm has a second length in the direction parallel to the longitudinal axis, and
the first length is greater than the second length.
10 . The prosthetic heart valve of claim 9 , wherein the first length is greater than the second length when the prosthetic heart valve is implanted in the heart.
11 . The prosthetic heart valve of claim 7 , wherein in an implanted configuration:
a first subset of the one or more ventricular arms is proximate to a ventricular side of a first the native leaflet, and
a second subset of the one or more ventricular arms is proximate to an atrial side of a second the native leaflet.
12 . The prosthetic heart valve of claim 11 , wherein, in the implanted configuration, at least one arm of a third subset of the one or more ventricular arms is proximate to at least one of: a commissure of the native heart or an atrial side of the first native leaflet.
13 . The prosthetic heart valve of claim 12 , wherein:
the at least one arm of the third subset has a first length in a direction parallel to a longitudinal axis of the prosthetic heart valve and another arm of the third subset has a second length in the direction parallel to the longitudinal axis, and the first length is greater than the second length.
14 . The prosthetic heart valve of claim 11 , wherein each arm of the first subset is configured such that the arms of the first subset, when in the implanted configuration, do not contact a native annulus of the heart, thereby reducing trauma to the heart.
15 . The prosthetic heart valve of claim 7 ,
wherein the cover is a ventricular cover disposed adjacent to a perimeter of the proximal ventricular segments, wherein the perimeter is opposite the cylindrical portion.
16 . The prosthetic heart valve of claim 7 ,
wherein the cover is a ventricular cover disposed adjacent to the proximal ventricular segments of the one or more ventricular arms, wherein a portion of the ventricular cover extends to be disposed adjacent to the distal ventricular segments of a subset of the one or more ventricular arms.
17 . The prosthetic heart valve of claim 7 , wherein the one or more ventricular arms is attached to an atrial end of the cylindrical portion of the at least one support structure.
18 . The prosthetic heart valve of claim 3 , wherein:
the distal atrial segment of the first atrial arm has a first distal end at a first distance from a longitudinal axis and a distal atrial segment of the second atrial arm has a second distal end at a second distance from the longitudinal axis, and
the distal atrial segment of the first atrial arm extends relative to the longitudinal axis such that the first distance is less than the second distance.
19 . The prosthetic heart valve of claim 3 , further comprising:
an atrial cover comprising a plurality of distal atrial covers configured to be disposed adjacent to the distal atrial segments of the one or more atrial arms.
20 . The prosthetic heart valve of claim 19 , wherein the plurality of distal atrial covers comprise one or more pleats such that the plurality of distal atrial covers is configured to expand or contract as a corresponding one of the one or more atrial arms increases or decreases in length.
21 . The prosthetic heart valve of claim 2 , wherein the cylindrical portion of the at least one support structure is radially collapsible for transcatheter implantation.
22 . The prosthetic heart valve of claim 1 , wherein the cover is configured to contact an atrial side of the native leaflet.
23 . The prosthetic heart valve of claim 1 , wherein the cover is configured to contact a ventricular side of the native leaflet.
24 . The prosthetic heart valve of claim 1 , wherein a bend region of a distal segment of the third set of arms is configured such that a clamping force is exerted on the native leaflet.