Heart valve assemblies
An implantable prosthetic valve assembly includes a radially expandable frame including an inflow portion and a second portion. The inflow portion is configured, in an expanded state, to bear against a native cardiac annulus in a manner so as to resist migration. The second portion extends from the inflow zone in an outflow direction, and is configured, in an expanded state, not to bear against the native cardiac annulus and an ascending aorta. The valve assembly also includes a prosthetic valve coupled to the frame substantially within the second portion.
1. An implantable prosthetic valve assembly comprising:
a radially expandable frame comprising,
an inflow portion that is configured, in an expanded state, to bear against a native cardiac annulus in a manner so as to resist migration,
a second portion extending from the inflow portion in an outflow direction, and configured, in an expanded state, not to bear against the native cardiac annulus and an ascending aorta,
an outflow portion extending from the second portion in the outflow direction, and configured, in an expanded state, to bear against the ascending aorta above a coronary ostia, and
a plurality of connection rods extending between the second portion and the outflow portion, wherein in an expanded state the plurality of connection rods are arranged uniformly on a periphery of the frame; and
a prosthetic valve coupled to the frame substantially within the second portion.
2. The assembly of claim 1 , wherein the outflow portion has a greater diameter than the second portion.
3. The assembly of claim 1 , wherein the inflow portion is configured for balloon expansion.
4. An implantable prosthetic valve assembly comprising:
a radially expandable frame comprising,
an inflow portion that is configured, in an expanded state, to bear against a native cardiac annulus in a manner so as to resist migration,
a second portion extending from the inflow portion in an outflow direction, and configured, in an expanded state, not to bear against the native cardiac annulus and an ascending aorta, wherein the second portion comprises a strut; and
a prosthetic valve coupled to the frame substantially within the second portion, wherein the prosthetic valve defines a passage,
wherein the prosthetic valve is axially movable with respect to the frame between a non-implantation position outside the second portion and an implantation position that occurs after expansion of the frame, in which the prosthetic valve is immobilized axially with respect to the frame, and
wherein the strut slides through the passage as the prosthetic valve moves from the non-implantation position to the implantation position.
5. The assembly of claim 4 , further comprising a band coupled to a peripheral wall of the prosthetic valve, and wherein the band has a shape memory so that the band keeps the prosthetic valve pressed against the frame in the implantation position.
6. The assembly of claim 5 , wherein the band comprises a wire.
7. The assembly of claim 1 , wherein the frame is configured to limit expansion of the prosthetic valve.
8. The assembly of claim 1 , wherein the second portion has a tapered diameter in the axial direction, and wherein the prosthetic valve has a corresponding shape.
9. The assembly of claim 1 , further comprising a sheath coupled to and at least partially covering the frame, the sheath comprising an impermeable biocompatible material.
10. The assembly of claim 1 , wherein the inflow portion has a greater diameter than the second portion.
11. The assembly of claim 1 , wherein the frame has an hourglass shape.
12. An implantable prosthetic valve assembly comprising:
a radially expandable frame comprising,
an inflow portion that is configured, in an expanded state, to bear against a native cardiac annulus in a manner so as to resist migration,
a second portion extending from the inflow portion in an outflow direction, and configured, in an expanded state, not to bear against the native cardiac annulus and an ascending aorta;
a prosthetic valve coupled to the frame substantially within the second portion; and
a sheath comprising an impermeable biocompatible material that at least partially covers the frame.
13. The assembly of claim 12 , wherein the sheath has lateral openings that are configured to be positioned opposite the coronary ostia when implanted.
14. The assembly of claim 1 , further comprising an inflatable peripheral chamber on the inflow portion and configured to be inflated to substantially form a seal between the frame and the native cardiac annulus.
15. The assembly of claim 1 , wherein the inflow portion comprises a tapered proximal portion having a diameter that decreases in the outflow direction and that is configured to, upon implantation, bear against a ventricle wall or corresponding auricle of the heart.
16. The assembly of claim 1 , further comprising retractable hooks on the frame to minimize migration.
17. The assembly of claim 4 , wherein the frame further comprises:
an outflow portion extending from the second portion in the outflow direction, and configured, in an expanded state, to bear against the ascending aorta above a coronary ostia.
18. The assembly of claim 17 , wherein the outflow portion has a greater diameter than the second portion.
19. The assembly of claim 13 , wherein the frame further comprises:
an outflow portion extending from the second portion in the outflow direction, and configured, in an expanded state, to bear against the ascending aorta above the coronary ostia.
20. The assembly of claim 19 , wherein the outflow portion has a greater diameter than the second portion.