Valve prosthesis
The present disclosure relates to valve replacement devices that are foldable for catheter-based deployment to the site of implantation, as well as systems for the delivery of valve prostheses, including prostheses having the special characteristics of the disclosed valve replacement devices. The devices include highly effective adhering mechanisms for secure and enduring precision implantation. The adhering mechanisms may employ a unique sealing mechanism that includes a cuff that expands slowly whereby the device is not secured in place until the completion of the implantation procedure. The implanted device, optionally together with the cuff, prevents perivalvular leaks and incorporate an appropriate leaflet system for reliable functioning in situ.
1. A mitral valve prosthesis comprising:
a stent having an expanded and an unexpanded state and that includes
a long axis;
a middle region having first and second ends and comprising a framework that defines inner and outer surfaces;
a lower flange portion at the first end of the middle region that comprises a plurality of flange elements forming an irregularly spaced array, each of said flange elements of the lower flange portion having a first end that is attached to the middle region and an opposed second end that is spaced from the first end of the flange elements of the lower flange portion;
an upper flange portion at the second end of the middle region that comprises a plurality of flange elements, each of said flange elements of the upper flange portion having a first end that is attached to the middle region and an opposed second end that is spaced from the first end of the flange elements of the upper flange portion,
wherein at least one flange element of one or both of the lower flange portion and the upper flange portion is fitted with a webbing
and,
a valve that is attached to the inner surface of the middle region of the stent,
wherein,
when said stent is in the unexpanded state, the upper and lower flange portions are oriented substantially along the long axis of the stent;
when said stent transitions from the unexpanded state to the expanded state, the lower flange portion transitions in space so that it is no longer oriented substantially along the long axis of the stent;
wherein the lower flange portion is oriented substantially parallel relative to the long axis of the stent when the stent is in the expanded state, and,
wherein the lower flange portion is adapted to grasp leaflets and chordae of a native mitral valve by enfolding the leaflets and chordae between the lower flange portion and the outer surface of the middle region in order to anchor the stent within a mitral annulus.
2. The mitral valve prosthesis according to claim 1 wherein the lower flange portion is adapted to anchor the stent within the mitral annulus by grasping a subvalvular apparatus at a ventricular side of the mitral annulus.
3. The mitral valve prosthesis according to claim 1 wherein the lower flange portion is adapted to anchor the stent within the mitral annulus by grasping a left ventricular wall.
4. The mitral valve prosthesis according to claim 1 wherein the upper flange portion is adapted to anchor the stent within the mitral annulus by grasping left atrial tissue.
5. The mitral valve prosthesis according to claim 1 wherein the lower flange portion is oriented substantially parallel relative to the long axis of the stent when the stent is in the unexpanded state.
6. The mitral valve prosthesis according to claim 1 wherein said stent is self-expanding.
7. The mitral valve prosthesis according to claim 1 wherein the stent comprises a wire weave.
8. The mitral valve prosthesis according to claim 1 wherein the upper flange portion is oriented at an oblique angle relative to the long axis of the stent when the stent is in the expanded state.
9. The mitral valve prosthesis according to claim 1 wherein the upper flange portion is oriented substantially parallel relative to the long axis of the stent when the stent is in the unexpanded state.
10. The mitral valve prosthesis according to claim 1 wherein when said stent transitions from the unexpanded state to the expanded state, the upper flange portion transitions in space so that it is no longer oriented substantially along the long axis of the stent.
11. The mitral valve prosthesis according to claim 10 wherein the upper flange portion is adapted to grasp tissue at an atrial side of the mitral annulus by enfolding it between the upper flange portion of the outer surface of the middle region as the stent transitions from the unexpanded state to the expanded state.
12. The mitral valve prosthesis according to claim 1 wherein when said stent transitions from the unexpanded state to the expanded state, the second ends of the flange elements of the lower flange portion move towards the middle region of the stent.
13. The mitral valve prosthesis according to claim 1 wherein when said stent transitions from the unexpanded state to the expanded state, the second ends of the flange elements of the upper flange portion move towards the middle region of the stent.
14. The mitral valve prosthesis according to claim 1 wherein when said stent transitions from the unexpanded state to the expanded state, the second ends of the flange elements of the lower flange portion orient away from the long axis of the stent.
15. The mitral The valve prosthesis according to claim 1 wherein when said stent transitions from the unexpanded state to the expanded state, the second ends of the flange elements of the upper flange portion orient away from the long axis of the stent.
16. The mitral valve prosthesis according to claim 1 , wherein the webbing comprises an absorbent material that expands by absorption of fluid.
17. The mitral valve prosthesis according to claim 1 , wherein at least one flange element of the lower flange portion is fitted with a webbing.
18. The mitral valve prosthesis according to claim 1 , wherein at least one flange element of both of the lower flange portion and the upper flange portion are fitted with a webbing.
19. The mitral valve prosthesis according to claim 1 , wherein the plurality of flange elements of the upper flange portion form a regularly spaced array.
20. The mitral valve prosthesis according to claim 1 , wherein at least some of the flange elements of the lower flange portion include a central portion that extends between the first end of the at least some of the flange elements of the lower flange portion and the second end of the at least some of the flange elements of the lower flange portion and that has a linear configuration when the stent is in the expanded state and when the stent is in the unexpanded state, and wherein the second end of the at least some of the flange elements of the lower flange portion comprises an arc that extends from the central portion.