Anchoring of a prosthetic valve
A prosthetic valve includes a tubular valve body, snares, and an upstream support. A native valve of a heart of a subject is disposed between an atrium and a ventricle of the heart, and has an annulus and leaflets. The prosthetic valve is advanced to the heart while in a compressed state. The prosthetic valve is positioned within the heart such that the snares are disposed upstream of the annulus and leaflets. The snares are expanded radially outwardly upstream of the leaflets. Subsequently, the prosthetic valve is moved in a downstream direction such that the snares become disposed downstream of the leaflets. While the snares remain downstream of the leaflets, the upstream support is expanded within the atrium, and the upstream support is placed against an upstream surface of the annulus. Other embodiments are also described.
1. A method for use with a native valve of a heart of a subject, the native valve being disposed between an atrium and a ventricle of the heart, and having an annulus and leaflets, the method comprising:
advancing a prosthetic valve to the heart while the prosthetic valve is in a compressed state thereof, the prosthetic valve including a tubular valve body, snares, and an upstream support;
positioning the prosthetic valve within the heart such that the snares are disposed upstream of the annulus and leaflets, and expanding the snares radially outwardly upstream of the leaflets;
subsequently, moving the prosthetic valve in a downstream direction such that the snares become disposed downstream of the leaflets; and
while the snares remain downstream of the leaflets, expanding the upstream support within the atrium and placing the upstream support against an upstream surface of the annulus and expanding the downstream portion of the valve body subsequently to expanding the snares.
2. The method according to claim 1 , wherein expanding the snares comprises expanding the snares while a downstream portion of the tubular valve body remains compressed.
3. The method according to claim 2 , wherein moving the prosthetic valve in the downstream direction comprises moving the prosthetic valve in the downstream direction while the downstream portion of the tubular valve body remains compressed.
4. The method according to claim 1 , wherein expanding the downstream portion of the valve body subsequently to expanding the snares comprises expanding the downstream portion of the valve body subsequently to expanding the upstream support portion within the atrium.
5. The method according to claim 4 , wherein expanding the downstream portion of the valve body comprises exposing the downstream portion of the valve body from a sheath such that the downstream portion of the valve body automatically expands.
6. The method according to claim 1 , further comprising, subsequently to moving the prosthetic valve in the downstream direction, and prior to expanding the upstream support within the atrium, moving the prosthetic valve back in an upstream direction such that the snares apply an upstream force to the leaflets.
7. The method according to claim 6 , wherein moving the prosthetic valve back in the upstream direction comprises placing the snares against the leaflets such that the snares inhibit further movement of the prosthetic valve in the upstream direction through the native valve.
8. The method according to claim 1 , wherein expanding the snares comprises expanding the snares such that the snares extend further upstream than the tubular valve body.
9. The method according to claim 1 , wherein positioning the prosthetic valve comprises identifying a position of the prosthetic valve within the heart using an imaging technique selected from the group consisting of: ultrasonography and fluoroscopy.
10. The method according to claim 1 , wherein expanding the upstream support within the atrium comprises expanding the upstream support while the tubular valve body is disposed between the leaflets.
11. The method according to claim 1 , wherein expanding the snares comprises exposing the snares from a sheath such that the snares automatically expand.
12. The method according to claim 1 , wherein advancing the prosthetic valve to the heart comprises transapically advancing the prosthetic valve to the heart.
13. The method according to claim 1 , wherein advancing the prosthetic valve to the heart comprises transfemorally advancing the prosthetic valve to the heart.