Prosthetic heart valve and delivery apparatus
The present disclosure is directed to embodiments of catheter-based prosthetic heart valves, and in particular, prosthetic heart valves having sealing members configured to seal the interface between the prosthetic valve and the surrounding tissue of the native annulus in which the prosthetic valve is implanted. The present disclosure also discloses new methods of making an introducer sheath with an inner liner for percutaneous insertion of a medical device into a patient.
1. A prosthetic heart valve, comprising:
a collapsible and expandable annular frame that is configured to be collapsed to a radially collapsed state for mounting on a delivery apparatus and expanded to a radially expanded state inside a body, the frame having an inflow end, an outflow end, and an outer surface and a longitudinal axis extending from the inflow end to the outflow end, the frame comprising a plurality of struts defining a plurality of cells;
a collapsible and expandable valve member mounted within the annular frame;
a collapsible and expandable skirt assembly mounted within the annular frame and comprising an upper skirt, a lower skirt, wherein a portion of the expandable valve member is secured between overlapping portions of the upper skirt and the lower skirt,
wherein along a cross section perpendicular to the longitudinal axis, the valve member is positioned radially outward from the lower skirt, the upper skirt is positioned radially outward from the valve member; and a sealing skirt is positioned radially outward from the upper skirt.
2. The prosthetic heart valve of claim 1 , wherein at least one of the upper skirt and the lower skirt prevents the sealing skirt from contacting the valve member, and configured such that when the annular frame is expanded to its radially expanded state inside the body, portions of the sealing skirt protrude outwardly through cells of the frame.
3. A prosthetic heart valve, comprising:
a collapsible and expandable annular frame that is configured to be collapsed to a radially collapsed state for mounting on a delivery apparatus and expanded to a radially expanded state inside a body, the frame having an inflow end, an outflow end, and an outer surface and a longitudinal axis extending from the inflow end to the outflow end, the frame comprising a plurality of struts defining a plurality of cells;
a collapsible and expandable valve member mounted within the annular frame;
a collapsible and expandable skirt assembly mounted within the annular frame and comprising an upper skirt, a lower skirt, and a sealing skirt, wherein along a cross section perpendicular to the longitudinal axis, the valve member is positioned radially outward from the lower skirt, the upper skirt is positioned radially outward from the valve member; and the sealing skirt is positioned radially outward from the upper skirt, wherein at least one of the upper skirt and the lower skirt prevents the sealing skirt from contacting the valve member, and configured such that when the annular frame is expanded to its radially expanded state inside the body, portions of the sealing skirt protrude outwardly through cells of the frame.
4. A prosthetic heart valve, comprising: a collapsible and expandable annular frame that is configured to be collapsed to a radially collapsed state for mounting on a delivery apparatus and expanded to a radially expanded state inside a body, the frame having an inflow end, an outflow end, and a longitudinal axis extending from the inflow end to the outflow end, the frame comprising a plurality of struts defining a plurality of rows of a plurality of cells; a collapsible and expandable valve member mounted within the annular frame; a collapsible and expandable skirt assembly mounted within the annular frame and comprising an upper skirt, a lower skirt, and a sealing skirt, wherein the upper and lower skirts prevent the sealing skirt from contacting the valve member, and wherein when the annular frame is expanded to its radially expanded state inside the body, portions of the sealing skirt protrude outwardly through cells of the frame to fill spaces between the frame and native tissue,
wherein along a cross section perpendicular to the longitudinal axis, the valve member is positioned radially outward from the lower skirt, the upper skirt is positioned radially outward from the valve member; and the sealing skirt is positioned radially outward from the upper skirt.
5. The prosthetic heart valve of claim 4 , wherein the sealing skirt is made of loop yarn.
6. The prosthetic heart valve of claim 4 , wherein the sealing skirt is mounted within the annular frame of the prosthetic heart valve by sutures that secure the sealing skirt and the lower skirt to the frame of the prosthetic heart valve.
7. The prosthetic heart valve of claim 4 , wherein the sealing skirt extends beyond the inflow end of the frame.
8. The prosthetic heart valve of claim 4 , wherein the sealing skirt comprises an upper edge and a lower edge shaped to correspond to the shape of a lower most row of cells of the frame.
9. The prosthetic heart valve of claim 4 , wherein the upper skirt comprises an upper edge shaped to correspond to a shape of an upper boundary of a second most lower row of cells of the frame.
10. The prosthetic heart valve of claim 4 , wherein, from the longitudinal axis:
the valve member is positioned radially outward from the lower skirt,
the upper skirt is positioned radially outward from the valve member; and
the sealing skirt is positioned radially outward from the upper skirt.
11. The prosthetic heart valve of claim 4 , wherein the lower skirt, the valve member, and the upper skirt are coupled to each other by sutures.
12. The prosthetic heart valve of claim 4 , wherein an outflow portion of the lower skirt is sutured to an inflow portion of the valve member; and the inflow portion of the valve member is sutured to an inflow portion of the upper skirt.
13. The prosthetic heart valve of claim 4 , wherein portions of the sealing skirt protrude radially outwardly through cells of the frame to seal against native tissue.
14. The prosthetic heart valve of claim 4 , wherein portions of the sealing skirt protrude radially outwardly through cells of the frame to seal against a surrounding annulus.
15. The prosthetic heart valve of claim 4 , wherein the length of the sealing skirt prior to mounting within the frame is longer than the circumference of the expanded annular frame.
16. The prosthetic heart valve of claim 4 , wherein the length of the sealing skirt prior to mounting within the frame is at least about 5% longer than the circumference of the expanded annular frame.
17. The prosthetic heart valve of claim 4 , wherein the length of the sealing skirt prior to mounting within the frame is at least about 15% longer than the circumference of the expanded annular frame.
18. The prosthetic heart valve of claim 4 , wherein the lower skirt and the upper skirt are different materials and are coupled to each other by sutures.
19. The prosthetic heart valve of claim 4 , wherein a portion of the expandable valve member is secured between a portion of the lower skirt and a portion of the upper skirt.
20. The prosthetic heart valve of claim 4 , wherein the sealing skirt comprises a plush material having fibers that protrude outwardly through cells of the frame when the annular frame is expanded to its radially expanded state.