Prosthetic heart valve and delivery apparatus
Prosthetic heart valves and methods of implantation thereof are disclosed herein. In embodiments, a prosthetic heart valve includes a self-expandable frame configured to support of valve member and comprising a plurality of interconnected strut members forming a mesh structure. An inflow end and outflow end portions of the mesh structure respectively define an inflow terminal end and an outflow terminal end of the frame. A portion of the frame tapers inwardly from the inflow terminal end to form a reduced diameter section. In implementations, the frame increases in diameter from the reduced diameter section to an intermediate section. In implementations, the valve member is secured to the frame at the inflow end portion. In implementations, the frame further comprises a plurality of retaining arms that extend from the outflow terminal end and are configured to engage with a valve retaining mechanism of a delivery apparatus.
1. A prosthetic heart valve comprising:
a valve member comprising an annular skirt and a plurality of leaflets, each of the plurality of leaflets having an inflow end section and an outflow end section, the annular skirt disposed at the inflow end section of each of the plurality of leaflets; and
a support frame configured to support the valve member and to be radially expandable and compressible, wherein the support frame comprises a plurality of strut members interconnected to each other to form a mesh structure, the mesh structure comprising an inflow end portion defining an inflow terminal end and an outflow end portion defining an outflow terminal end;
wherein at least a portion of the support frame has a curved shape that tapers inwardly from the inflow terminal end to a reduced diameter section and increases in diameter from the reduced diameter section to an intermediate section;
wherein the support frame further comprises a plurality of angularly spaced retaining arms that extend from the outflow terminal end and are configured to releasably engage with a complementarily configured valve-retaining mechanism of a delivery apparatus;
wherein the inflow end section of each of the plurality of leaflets is coupled to the support frame with sutures that secure the annular skirt to at least some of the plurality of struts at the inflow end portion of the support frame; and
wherein the inflow end portion comprises a flared annular collar disposed between the reduced diameter section and the inflow terminal end.
2. The prosthetic heart valve of claim 1 , wherein the plurality of strut members form a plurality of adjacent alternating bends and are secured to each other at one or more nodes formed by vertices of adjacent ones of the plurality of alternating bends.
3. The prosthetic heart valve of claim 1 , wherein the plurality of leaflets define a plurality of angularly spaced commissures that are secured to the inside of the support frame at the outflow end portion.
4. The prosthetic heart valve of claim 3 , wherein each of the plurality of angularly spaced commissures is formed by securing adjacent edges of the outflow end section of the plurality of leaflets to the inside of the support frame at the outflow end portion.
5. The prosthetic heart valve of claim 4 , further comprising a plurality of reinforcement elements, each of the plurality of reinforcement elements attached to the support frame and to the adjacent edges of the outflow end section, the plurality of reinforcement elements configured to minimize stress concentration at the adjacent edges of the outflow end section of each of the plurality of leaflets during operation of the prosthetic heart valve.
6. The prosthetic heart valve of claim 5 , wherein the adjacent edges of the outflow end section of each of the plurality of leaflets comprise a pair of complementary tabs extending outwardly from adjacent ones of the plurality of leaflets, wherein each of the plurality of reinforcement elements comprises a fabric material sutured to the pair of complementary tabs which are folded outwardly such that they are disposed on an exterior surface of the valve member, and wherein the fabric material is further sutured to the support frame.
7. The prosthetic heart valve of claim 1 , wherein the prosthetic heart valve is configured to be implanted in a native aortic valve with the reduced diameter section residing within an annulus of the native aortic valve, the inflow terminal end extending below the annulus and the intermediate section extending above the annulus, and wherein the outflow terminal end is spaced from an inner wall of the aorta.
8. The prosthetic heart valve of claim 1 , wherein, when the prosthetic heart valve is in an expanded state, the intermediate section has a first diameter (D 1 ), the reduced diameter section has a second, minimum diameter (D 2 ), and the inflow terminal end has a third diameter (D 3 ), wherein the second diameter (D 2 ) is less than the first and third diameters (D 1 , D 3 ).
9. The prosthetic heart valve of claim 1 , wherein each of the plurality of angularly spaced retaining arms comprises a stem portion and a head portion, the stem portion connected to the outflow terminal end of the support frame.
10. A prosthetic heart valve comprising:
a valve member comprising an annular skirt and a plurality of leaflets, each of the plurality of leaflets having an inflow end section and an outflow end section, the annular skirt disposed at the inflow end section of each of the plurality of leaflets; and
a support frame configured to support the valve member and to be radially expandable and compressible, wherein the support frame comprises a plurality of strut members interconnected to each other to form a mesh structure, the mesh structure comprising an inflow end portion defining an inflow terminal end and an outflow end portion defining an outflow terminal end;
wherein at least a portion of the support frame has a curved shape that tapers inwardly from the inflow terminal end to a reduced diameter section and increases in diameter from the reduced diameter section to an intermediate section;
wherein the support frame further comprises a plurality of angularly spaced retaining arms that extend from the outflow terminal end and are configured to releasably engage with a complementarily configured valve-retaining mechanism of a delivery apparatus;
wherein the inflow end section of each of the plurality of leaflets is coupled to the support frame with sutures that secure the annular skirt to at least some of the plurality of struts at the inflow end portion of the support frame;
wherein the plurality of leaflets define a plurality of angularly spaced commissures that are secured to the inside of the support frame at the outflow end portion wherein each of the plurality of angularly spaced commissures is formed by securing adjacent edges of the outflow end section of the plurality of leaflets to the inside of the support frame at the outflow end portion;
the prosthetic heart valve further comprising a plurality of reinforcement elements, each of the plurality of reinforcement elements attached to the support frame and to the adjacent edges of the outflow end section, the plurality of reinforcement elements configured to minimize stress concentration at the adjacent edges of the outflow end section of each of the plurality of leaflets during operation of the prosthetic heart valve;
wherein the adjacent edges of the outflow end section of each of the plurality of leaflets comprise a pair of complementary tabs extending outwardly from adjacent ones of the plurality of leaflets, and wherein each of the plurality of the reinforcement elements comprises a fabric material sutured to the pair of complementary tabs which are folded outwardly such that they are disposed on an exterior surface of the valve member, and wherein the fabric material is further sutured to the support frame.
11. A prosthetic heart valve comprising:
a valve member comprising an annular skirt and a plurality of leaflets, each of the plurality of leaflets having an inflow end section and an outflow end section, the annular skirt disposed at the inflow end section of each of the plurality of leaflets; and
a support frame configured to support the valve member and to be radially expandable and compressible, wherein the support frame comprises a plurality of strut members interconnected to each other to form a mesh structure, the mesh structure comprising an inflow end portion defining an inflow terminal end and an outflow end portion defining an outflow terminal end;
wherein at least a portion of the support frame has a curved shape that tapers inwardly from the inflow terminal end to a reduced diameter section and increases in diameter from the reduced diameter section to an intermediate section;
wherein the support frame further comprises a plurality of angularly spaced retaining arms that extend from the outflow terminal end and are configured to releasably engage with a complementarily configured valve-retaining mechanism of a delivery apparatus;
wherein the inflow end section of each of the plurality of leaflets is coupled to the support frame with sutures that secure the annular skirt to at least some of the plurality of struts at the inflow end portion of the support frame; and
wherein the plurality of leaflets define a plurality of angularly spaced commissures that are secured to the inside of the support frame at the outflow end portion.
12. The prosthetic heart valve of claim 11 , wherein each of the plurality of angularly spaced commissures is formed by securing adjacent edges of the outflow end section of the plurality of leaflets to the inside of the support frame at the outflow end portion.
13. The prosthetic heart valve of claim 11 , wherein the inflow end portion comprises a flared annular collar disposed between the reduced diameter section and the inflow terminal end.
14. The prosthetic heart valve of claim 11 , wherein the prosthetic heart valve is configured to be implanted in a native aortic valve with the reduced diameter section residing within an annulus of the native aortic valve, the inflow terminal end extending below the annulus and the intermediate section extending above the annulus, and wherein the outflow terminal end is spaced from an inner wall of the aorta.
15. A prosthetic heart valve comprising:
a valve member comprising an annular skirt and a plurality of leaflets, each of the plurality of leaflets having an inflow end section and an outflow end section, the annular skirt disposed at the inflow end section of each of the plurality of leaflets; and
a support frame configured to support the valve member and to be radially expandable and compressible, wherein the support frame comprises a plurality of strut members interconnected to each other to form a mesh structure, the mesh structure comprising an inflow end portion defining an inflow terminal end and an outflow end portion defining an outflow terminal end;
wherein at least a portion of the support frame has a curved shape that tapers inwardly from the inflow terminal end to a reduced diameter section and increases in diameter from the reduced diameter section to an intermediate section;
wherein the support frame further comprises a plurality of angularly spaced retaining arms that extend from the outflow terminal end and are configured to releasably engage with a complementarily configured valve-retaining mechanism of a delivery apparatus;
wherein the inflow end section of each of the plurality of leaflets is coupled to the support frame with sutures that secure the annular skirt to at least some of the plurality of struts at the inflow end portion of the support frame; and
wherein, when the prosthetic heart valve is in an expanded state, the intermediate section has a first diameter (D 1 ), the reduced diameter section has a second, minimum diameter (D 2 ), and the inflow terminal end has a third diameter (D 3 ), wherein the second diameter (D 2 ) is less than the first and third diameters (D 1 , D 3 ).
16. The prosthetic heart valve of claim 15 , wherein the inflow end portion comprises a flared annular collar disposed between the reduced diameter section and the inflow terminal end.
17. The prosthetic heart valve of claim 15 , wherein the prosthetic heart valve is configured to be implanted in a native aortic valve with the reduced diameter section residing within an annulus of the native aortic valve, the inflow terminal end extending below the annulus and the intermediate section extending above the annulus, and wherein the outflow terminal end is spaced from an inner wall of the aorta.