Prosthetic heart valve with atrial drain
A prosthetic heart valve includes an outer frame, an outer sealing skirt, an inner frame, an inner sealing skirt, a plurality of prosthetic leaflets mounted within the inner frame, and a plurality of connecting arms connecting the inner frame to the outer frame so that the inner frame is positioned radially inward of the outer frame. A bridging skirt extends from the outer sealing skirt to an inflow edge of the inner sealing skirt. The bridging skirt covers a gap between the inner frame and the outer frame. The inner sealing skirt may include at least one trench that interrupts an otherwise circular shape of the inflow edge of the inner sealing skirt, the trench extending in an outflow direction of the prosthetic heart valve.
1 . A prosthetic heart valve for replacing a native heart valve, the prosthetic heart valve comprising:
a collapsible and expandable outer frame configured to be positioned within an annulus of the native heart valve, an outer sealing skirt being positioned on a luminal or abluminal surface of the outer frame;
a collapsible and expandable inner frame;
an inner sealing skirt positioned on a luminal or abluminal surface of the inner frame;
a plurality of prosthetic leaflets coupled to the inner sealing skirt or the inner frame, and positioned within the inner frame;
a plurality of connecting arms connecting the inner frame to the outer frame so that the inner frame is positioned radially inward of the outer frame; and
a bridging skirt extending from the outer sealing skirt to an inflow edge of the inner sealing skirt, the bridging skirt covering a gap between the inner frame and the outer frame, wherein the inner sealing skirt includes at least one trench that interrupts an otherwise circular shape of the inflow edge of the inner sealing skirt, the trench being sloped to empty residual fluid toward an outflow direction of the prosthetic heart valve.
2 . The prosthetic heart valve of claim 1 , wherein the inner frame includes cells arranged circumferentially in an atrial row of cells.
3 . The prosthetic heart valve of claim 2 , wherein the at least one trench forms a “V”-shape that follows struts of two circumferentially adjacent cells in the atrial row of cells.
4 . The prosthetic heart valve of claim 3 , wherein the at least one trench includes a plurality of trenches.
5 . The prosthetic heart valve of claim 4 , wherein the plurality of trenches includes three trenches.
6 . The prosthetic heart valve of claim 5 , wherein the inner frame includes three commissure attachment features extending at an outflow end of the inner frame, adjacent ones of the plurality of prosthetic leaflets being coupled to a corresponding one of the commissure attachment features, each of the three trenches being axially aligned with a corresponding one of the three commissure attachment features.
7 . The prosthetic heart valve of claim 4 , wherein, the inflow edge of the inner sealing skirt traverses a circumferential arc along an inflow end of the inner frame in a circumferential direction of the inner frame between circumferentially adjacent pairs of the plurality of trenches, so that the “V”-shapes of the plurality of trenches are positioned in the outflow direction of the prosthetic heart valve compared to the arc.
8 . The prosthetic heart valve of claim 7 , wherein the bridging skirt includes an outer perimeter attached to the outer sealing skirt, and an inner perimeter attached to the inner sealing skirt.
9 . The prosthetic heart valve of claim 8 , wherein the inner perimeter of the bridging skirt follows the circumferential arc of the inflow edge of the inner sealing skirt between adjacent pairs of the plurality of trenches, and follows the “V”-shapes of the plurality of trenches at the trenches.
10 . The prosthetic heart valve of claim 9 , wherein in an expanded condition of the prosthetic heart valve, bottoms of the “V”-shapes of the plurality of trenches are positioned at outflow-most positions of the bridging skirt.
11 . The prosthetic heart valve of claim 10 , wherein in an implanted condition of the prosthetic heart valve, the bridging skirt in combination with the inner sealing skirt form flow pathways that preferentially channel blood that flows toward the bridging skirt to drain into the inner frame via the plurality of trenches.
12 . The prosthetic heart valve of claim 1 , wherein the plurality of connecting arms have a first end coupled to the inner frame, and a second free end opposite the first end, the second free ends of the plurality of connecting arms being coupled to the outer frame.
13 . The prosthetic heart valve of claim 12 , wherein the second free ends of the plurality of connecting arms each define an aperture, the second free ends of the plurality of connecting arms being coupled to the outer frame via fasteners passing through the apertures.
14 . The prosthetic heart valve of claim 13 , wherein the fasteners are sutures or rivets.
15 . The prosthetic heart valve of claim 12 , wherein the first end of each of the plurality of connecting arms is formed integrally with the inner frame.
16 . The prosthetic heart valve of claim 12 , wherein in an expanded condition of the prosthetic heart valve, the plurality of connecting arms maintain an inflow end of the inner frame at an axial distance from an inflow end of the outer frame, so that the inflow end of the outer frame is positioned in an outflow direction of the prosthetic heart valve relative to the inflow end of the inner frame.
17 . The prosthetic heart valve of claim 1 , wherein the outer sealing skirt is a separate structure from the bridging skirt, and the bridging skirt is a separate structure from the inner sealing skirt.
18 . The prosthetic heart valve of claim 17 , wherein an outer perimeter of the bridging skirt is sutured to the outer sealing skirt, and an inner perimeter of the bridging skirt is sutured to the inner sealing skirt.
19 . The prosthetic heart valve of claim 18 , wherein the bridging skirt is sutured to the plurality of connecting arms.
20 . The prosthetic heart valve of claim 1 , wherein the prosthetic heart valve is sized and shaped for replacing a native right atrioventricular valve.