Devices and methods of commissure formation for prosthetic heart valve
A prosthetic valve has an annular frame including a plurality of strut members that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration. A leaflet structure is situated at least partially within the frame. The leaflet structure includes a plurality of leaflets, each leaflet having opposing commissure tab portions on opposite sides of the leaflet. Each commissure tab portion is paired with an adjacent commissure tab portion of an adjacent leaflet to form a commissure. The commissure tab portions of each leaflet are folded to form a plurality of layers positioned on the inside of the frame. A reinforcement member is positioned between the layers of each commissure tab portion.
1. A prosthetic valve, comprising:
an annular frame including a plurality of strut members, the frame being radially collapsible to a collapsed configuration and radially expandable to an expanded configuration;
a leaflet structure situated at least partially within the frame, the leaflet structure comprising a plurality of leaflets, each leaflet comprising opposing commissure tab portions on opposite sides of the leaflet, each commissure tab portion being paired with an adjacent commissure tab portion of an adjacent leaflet to form a commissure, the commissure tab portions of each leaflet being folded such that each commissure tab portion forms a plurality of layers, and the plurality of layers of each commissure tab portion are positioned on the inside of the frame; and
a plurality of reinforcement members, a reinforcement member of the plurality of reinforcement members being positioned between the layers of each commissure tab portion;
wherein each commissure tab portion is folded along two fold lines that are orthogonal to each other.
2. The prosthetic valve of claim 1 , wherein the commissure tab portions of each leaflet are folded to form four layers, and a reinforcement member of the plurality of reinforcement members is positioned between second and third layers of each commissure tab portion.
3. The prosthetic valve of claim 1 , wherein a reinforcement member of the plurality of reinforcement members is positioned in a center of each folded commissure tab portion.
4. The prosthetic valve of claim 1 , further comprising a commissure attachment member at the commissure, and wherein the commissure tab portions of the commissure are received in the commissure attachment member.
5. The prosthetic valve of claim 4 , wherein the commissure attachment member is folded to form a central outer portion positioned along an inner surface of the frame and first and second side portions extending inwardly from the central outer portion.
6. The prosthetic valve of claim 5 , wherein the first and second side portions of the commissure attachment member each comprise first and second layers.
7. The prosthetic valve of claim 6 , wherein end portions extend from the first and second side portions of the commissure attachment member and form one of the first or second layers of the commissure attachment member.
8. The prosthetic valve of claim 5 , wherein each side portion of the commissure attachment member is secured to a commissure tab portion of the commissure by suturing.
9. The prosthetic valve of claim 4 , wherein the commissure attachment member comprises an inner sleeve, and the inner sleeve extends around the commissure tab portions of the commissure.
10. The prosthetic valve of claim 4 , further comprising an outer support member coupled to the commissure attachment member, at least a portion of the outer support member being positioned outside the frame.
11. The prosthetic valve of claim 1 , wherein the reinforcement members comprise fabric.
12. A prosthetic valve, comprising:
an annular frame including a plurality of strut members, the frame being radially collapsible to a collapsed configuration and radially expandable to an expanded configuration;
a leaflet structure situated at least partially within the frame, the leaflet structure comprising a plurality of leaflets, each leaflet comprising opposing commissure tab portions on opposite sides of the leaflet, each commissure tab portion being paired with an adjacent commissure tab portion of an adjacent leaflet to form a commissure, the commissure tab portions of each leaflet being folded such that each commissure tab portion forms a plurality of layers, and the plurality of layers of each commissure tab portion are positioned on the inside of the frame; and
a commissure attachment member positioned at the commissure, the commissure attachment member comprising an inner sleeve;
wherein the commissure tab portions of the commissure are received in the inner sleeve of the commissure attachment member; and
wherein each commissure tab portion is folded along two fold lines that are orthogonal to each other.
13. The prosthetic valve of claim 12 , further comprising a reinforcement member positioned between the folded layers of each commissure tab portion.
14. The prosthetic valve of claim 13 , wherein the reinforcement members of the commissure are received in the inner sleeve of the commissure attachment member.
15. The prosthetic valve of claim 13 , wherein the reinforcement member of each commissure tab portion, a side portion of the inner sleeve, and the layers of the commissure tab portion that are between the reinforcement member and the side portion of the inner sleeve, are secured together by suturing.
16. The prosthetic valve of claim 12 , further comprising an outer support member coupled to the commissure attachment member, at least a portion of the outer support member being positioned outside the frame.
17. The prosthetic valve of claim 16 , wherein the outer support member extends over an outflow end of the frame to the outside of the frame.
18. A prosthetic valve, comprising:
an annular frame including a plurality of strut members, the frame being radially collapsible to a collapsed configuration and radially expandable to an expanded configuration;
a leaflet structure situated at least partially within the frame, the leaflet structure comprising a plurality of leaflets, each leaflet comprising opposing commissure tab portions on opposite sides of the leaflet, each commissure tab portion being paired with an adjacent commissure tab portion of an adjacent leaflet to form a commissure, the commissure tab portions of each leaflet being folded such that each commissure tab portion forms a plurality of layers, and the plurality of layers of each commissure tab portion are positioned on the inside of the frame;
a plurality of reinforcement members, a reinforcement member of the plurality of reinforcement members being positioned between the layers of each commissure tab portion; and
a commissure attachment member positioned at the commissure, the commissure attachment member comprising an inner sleeve;
wherein the commissure tab portions and the reinforcement members of the commissure are received in the inner sleeve of the commissure attachment member; and
wherein each commissure tab portion is folded along two fold lines that are orthogonal to each other.