Prosthetic heart valve
A prosthetic heart valve can include a radially expandable and compressible frame having an inflow end, an outflow end, and a plurality of struts. The prosthetic valve can further include a valvular structure comprising a plurality of leaflets, each leaflet comprising a coaptation edge portion and a cusp edge portion. The cusp edge portion of each leaflet can be folded toward the outflow end of the frame along a bending axis and a reinforcing member extends along an outflow surface of the cusp edge portion along the bending axis. The prosthetic heart valve can include a plurality of connecting skirts, each disposed between the cusp edge portion of an adjacent leaflet and the frame. First stitching secures the reinforcing member and the connecting skirts to the cusp edge portions and second stitching secures the connecting skirts to selected struts of the frame.
1. A prosthetic heart valve, comprising:
a radially expandable and compressible frame having an inflow end and an outflow end, the frame comprising a plurality of struts defining openings between them;
a valvular structure comprising a plurality of leaflets, each leaflet comprising a main body having an inflow surface, an outflow surface opposing the inflow surface, an edge surface extending from the inflow surface to the outflow surface and defining a thickness of the leaflet, a coaptation edge portion, and a cusp edge portion, the cusp edge portion of each leaflet being folded toward the outflow end of the frame along a bending axis to form an outer fold layer that extends parallel to a longitudinal axis of the frame such that the edge surface faces the outflow end of the frame;
a reinforcing member separate from the frame extending along the bending axis between the outer fold layer and the outflow surface of the main body of each leaflet of the plurality of leaflets;
a plurality of connecting skirts, wherein each connecting skirt is disposed between the cusp edge portion of an adjacent leaflet and the frame;
first stitching securing the reinforcing member and the connecting skirts to the cusp edge portions of the leaflets; and
second stitching securing the connecting skirts to selected struts of the frame.
2. The prosthetic heart valve of claim 1 , wherein along the cusp edge portion of each leaflet, the first stitching extends only through the reinforcing member, the connecting skirt, and the cusp edge portion.
3. The prosthetic heart valve of claim 2 , wherein the second stitching includes whip stitches that extend through each of the connecting skirts and around the selected struts of the frame.
4. The prosthetic heart valve of claim 3 , wherein the whip stitches do not extend through the reinforcing member, the connecting skirts, and the cusp edge portions.
5. The prosthetic heart valve of claim 1 , wherein each connecting skirt comprises a central portion and first and second side portions, and wherein the central portion is partially separated from each of the first and the second side portions by two or more slits.
6. The prosthetic heart valve of claim 1 , wherein each leaflet has opposing edge portions between opposing commissure tabs and the cusp edge portion that are unattached to the frame, each unattached edge portion defining a notch in the leaflet.
7. The prosthetic heart valve of claim 1 , wherein each leaflet comprises a pair of opposing commissure tabs, wherein each commissure tab is paired with an adjacent commissure tab of an adjacent leaflet to form a plurality of commissures that are fixed relative to the frame, and wherein each commissure is coupled to a commissure attachment member, each commissure attachment member comprising first and second side portions extending laterally from a central portion.
8. The prosthetic heart valve of claim 7 , wherein outer peripheral edges of the first and the second side portions of the commissure attachment member are shaped such that each outer peripheral edge corresponds to one half of a diamond shaped cell of the frame.
9. The prosthetic heart valve of claim 1 , wherein the reinforcing member comprises a multi-filament suture.
10. A prosthetic heart valve, comprising:
a radially expandable and compressible frame having an inflow end and an outflow end, the frame comprising a plurality of struts defining openings between them;
a valvular structure comprising exactly three leaflets, each leaflet comprising a main body having an inflow surface, an outflow surface opposing the inflow surface, an edge surface extending from the inflow surface to the outflow surface and defining a thickness of the leaflet, a coaptation edge portion, and a cusp edge portion; and
exactly three connecting skirts, wherein each connecting skirt is stitched to the cusp edge portion of an adjacent leaflet and is disposed between the cusp edge portion and the frame, wherein each connecting skirt comprises a central portion and first and second side portions, and wherein the central portion is partially separated from each of the first and the second side portions by one or more linear slits that extend from a side edge of the connecting skirt into a main body of the connecting skirt and through a thickness of the connecting skirt;
wherein the central portion of each connecting skirt extends over a lower central portion of a cusp edge portion on the inflow surface of the leaflet and the first and the second side portions extend over opposing side portions of the cusp edge portion on the inflow surface of the leaflet, and
wherein each leaflet is folded toward the outflow end of the frame along a bending axis to form a respective outer fold layer that extends parallel to a longitudinal axis of the frame such that the respective edge surface of each leaflet faces the outflow end of the frame.
11. The prosthetic heart valve of claim 10 , wherein the one or more slits of each connecting skirt comprises a first pair of first and second opposing slits separating the central portion from the first side portion and a second pair of first and second opposing slits separating the central portion from the second side portion.
12. The prosthetic heart valve of claim 10 , wherein:
the cusp edge portion of each leaflet is folded toward the outflow end of the frame along a bending axis; and
a reinforcing member separate from the frame that extends along and is secured to an outflow surface of the cusp edge portion of each leaflet along the bending axis.
13. The prosthetic heart valve of claim 12 , further comprising a plurality of first stitches securing the cusp edge portion of each leaflet to the reinforcing member and a corresponding connecting skirt of the plurality of connecting skirts.
14. The prosthetic heart valve of claim 13 , further comprising a plurality of second stitches securing the plurality of connecting skirts including the corresponding connecting skirt to selected struts of the frame.
15. The prosthetic heart valve of claim 10 , further comprising a sealing member disposed on an outer surface of the frame.
16. A prosthetic heart valve, comprising:
a radially expandable and compressible frame having an inflow end and an outflow end, the frame comprising a plurality of struts defining openings between them;
a valvular structure comprising a plurality of leaflets, each leaflet comprising a main body having an inflow surface, an outflow surface opposing the inflow surface, an edge surface extending from the inflow surface to the outflow surface and defining a thickness of the leaflet, a coaptation edge portion, and a cusp edge portion, the cusp edge portion of each leaflet being folded toward the outflow end of the frame along a bending axis to form an outer fold layer extending from the main body, the outer fold layer including the edge surface, wherein the edge surface of the outer fold layer faces the outflow end of the frame;
a reinforcing member extending along the bending axis between the outer fold layer and the outflow surface of the main body of each leaflet of the plurality of leaflets;
a plurality of connecting skirts, wherein each connecting skirt is disposed between the outer fold layer of each leaflet and the frame;
a plurality of first stitches extending only through the connecting skirt, the outer fold layer, and the reinforcing member along each leaflet; and
a plurality of second stitches securing each connecting skirt to selected struts of the frame.
17. The prosthetic valve of claim 16 , wherein the second stitches comprise whip stitches that extend around the selected struts of the frame.
18. The prosthetic valve of claim 16 , wherein each connecting skirt comprises a central portion and first and second side portions, and wherein the central portion is partially separated from the first and the second side portions by two or more slits.