Stationary intra-annular halo designs for paravalvular leak (PVL) reduction—active channel filling cuff designs
A prosthetic heart valve may include a collapsible and expandable stent extending in a flow direction between a proximal end and a distal end, a cuff attached to an annulus section of the stent and having an outer surface facing in a radial direction orthogonal to the flow direction, a plurality of prosthetic valve leaflets attached to the cuff, and a sealing structure attached to the annulus section of the stent at an inner edge of the sealing structure. The flow direction may be defined from the proximal end toward the distal end. The sealing structure may have an outer edge remote from the inner edge. The sealing structure may have a collapsed condition with the outer edge disposed adjacent the outer surface of the cuff and an expanded condition with the outer edge spaced apart from the outer surface of the cuff.
1. A prosthetic heart valve configured to be expanded in an annulus of a native aortic valve of a patient, the prosthetic heart valve comprising:
a stent extending in a flow direction from an inflow end to an outflow end, the stent having an expanded condition and a collapsed condition and including an annulus section adjacent the inflow end and a plurality of struts shaped to form a plurality of cells connected to one another in a plurality of annular rows around the stent, each of the cells having a maximum width in the expanded condition;
a cuff attached to the annulus section of the stent and having an outer surface facing in radial directions orthogonal to the flow direction;
a plurality of prosthetic valve leaflets attached to the cuff; and
a plurality of sealing members in the annulus section of the stent, each sealing member having a first end, a second end, an open side facing toward the outflow end of the stent and a closed side facing toward the inflow end of the stent so that blood flowing in a direction opposite the flow direction can enter at least one of the sealing members through the open side and cause an outer surface of the at least one sealing member to move away from the outer surface of the cuff, the open side of each of the sealing members having a width in a circumferential direction of the stent from the first end to the second end, the width of the open side of a group of the sealing members being greater than the maximum width of at least one cell in the expanded condition.
2. The prosthetic heart valve as claimed in claim 1 , wherein the width of the open side of each of the sealing members is greater than the maximum width of at least one cell in the expanded condition.
3. The prosthetic heart valve as claimed in claim 1 , wherein the width of the open side of each of the sealing members is greater than a maximum combined width of at least two adjacent cells in the expanded condition.
4. The prosthetic heart valve as claimed in claim 1 , wherein the width of the open side of each of the sealing members extends across the maximum width of three adjacent cells in the expanded condition.
5. The prosthetic heart valve as claimed in claim 4 , wherein
the stent includes commissure features each located at a juncture of adjacent ones of the leaflets,
at least a portion of each leaflet is attached to one of the commissure features, and
each of the sealing members is substantially aligned in the flow direction with a respective one of the commissure features.
6. The prosthetic heart valve as claimed in claim 1 , wherein each of the sealing members has a shape selected from the group consisting of triangular, crescent-shaped, rectangular or square.
7. The prosthetic heart valve as claimed in claim 1 , wherein
each leaflet is attached to the cuff along a belly portion, the belly portion including an attachment point at which the leaflet is closest to the inflow end of the stent,
each of the attachment points is at a predetermined distance from the inflow end of the stent,
the attachment points collectively define a positioning line circumscribing a circumference of the stent at the predetermined distance from the inflow end of the stent, and
the open side of each of the sealing members is located between the outflow end of the stent and the positioning line.
8. The prosthetic heart valve as claimed in claim 1 , wherein
each leaflet is attached to the cuff along a belly portion, the belly portion including an attachment point at which the leaflet is closest to the inflow end of the stent,
each of the attachment points is at a predetermined distance from the inflow end of the stent,
the attachment points collectively define a positioning line circumscribing a circumference of the stent at the predetermined distance from the inflow end of the stent, and
the open side of each of the sealing members is located between the inflow end of the stent and the positioning line.
9. The prosthetic heart valve as claimed in claim 1 , wherein the cuff is attached to the stent by cuff sutures, and the plurality of sealing members are attached to the stent by the cuff sutures.
10. The prosthetic heart valve as claimed in claim 1 , wherein
the stent includes commissure features each located at a juncture of adjacent ones of the leaflets,
at least a portion of each leaflet is attached to one of the commissure features, and
each of the sealing members is substantially aligned in the flow direction with a respective one of the commissure features.
11. The prosthetic heart valve as claimed in claim 1 , wherein
each leaflet is attached to the cuff along a belly portion, the belly portion including an attachment point at which the leaflet is closest to the inflow end of the stent,
the stent includes commissure features each located at a juncture of adjacent ones of the leaflets,
at least a portion of each leaflet is attached to one of the commissure features,
each of the sealing members in a first series of the sealing members is substantially aligned in a flow direction with a respective one of the commissure features, and
each of the sealing members in a second series of the sealing members is substantially aligned in the flow direction between adjacent ones of the commissure features.
12. The prosthetic heart valve as claimed in claim 1 , wherein the plurality of sealing members include lower sealing members and upper sealing members, the upper sealing members being spaced in the flow direction of the stent above the lower sealing members.
13. The prosthetic heart valve as claimed in claim 1 , wherein
the plurality of sealing members include a group of lower sealing members and a group of upper sealing members,
the open sides of the sealing members in the group of lower sealing members are spaced a first distance from the inflow end of the stent in the flow direction, and
the open sides of the sealing members in the group of upper sealing members are spaced a second distance from the inflow end of the stent in the flow direction, the second distance being greater than the first distance.
14. The prosthetic heart valve as claimed in claim 13 , wherein
the open sides of the sealing members in the group of lower sealing members are spaced apart about a circumference of the stent by first openings,
the open sides of the sealing members in the group of upper sealing members are spaced apart about the circumference of the stent by second openings,
the open sides of the sealing members in the group of upper sealing members are aligned in the flow direction with the first openings, and
the open sides of the sealing members in the group of lower sealing members are aligned in the flow direction with the second openings, such that any blood flow in a direction opposite the flow direction along the outer surface of the cuff will encounter the open side of at least one sealing member.
15. The prosthetic heart valve as claimed in claim 13 , wherein
the stent include a plurality of commissure features each located at a juncture of adjacent ones of the leaflets, each of the commissure features being located a third distance from the inflow end of the stent, and
the open side of each of the sealing members in the group of upper sealing members and the open side of each of the sealing members in the group of lower sealing members are located between the inflow end of the stent and the third distance.
16. The prosthetic heart valve as claimed in claim 13 , wherein
the stent includes a plurality of commissure features each located at a juncture of adjacent ones of the leaflets,
at least a portion of each leaflet is attached to one of the commissure features, and
each of the sealing members in the group of lower sealing members is substantially aligned in the flow direction with a respective one of the commissure features.