System for replacing a native valve of the heart
A system for replacing a native valve of the heart includes a delivery apparatus having a sheath and a prosthetic valve. The prosthetic valve includes a frame having an annular main body, a plurality of ventricular anchors attached to the main body, an atrial anchor attached to an atrial end portion of the main body, and a valve structure disposed within the main body of the frame. The prosthetic valve is disposed within a distal end portion of the sheath in a compressed, delivery state. When the prosthetic valve is deployed from the sheath, the main body of the frame radially expands to a radially expanded state, the ventricular anchors expand to a deployed state alongside the main body of the frame for capturing native leaflets of the native valve, and the atrial anchor expands to a deployed state extending radially outwardly from the main body.
1. A system for replacing a native valve of the heart, the native valve having a native annulus and native valve leaflets, the system comprising:
a delivery apparatus comprising a sheath and a pusher shaft extending through the sheath, wherein the delivery apparatus is steerable within a vasculature of a patient; and
a prosthetic valve comprising:
a main body comprising a lumen and configured for placement within the native annulus, the main body being radially compressible to a radially compressed state for delivery into the heart and self-expandable from the compressed state to a radially expanded state;
a valve structure coupled to the inner surface of the main body, the valve structure comprising a plurality of valve leaflets that form a one-way valve in the lumen;
at least two ventricular anchors extending from a ventricular end portion of the main body and disposed outside of the main body for securing the prosthetic valve to the native leaflets, wherein the ventricular anchors are configured to capture the native valve leaflets between the ventricular anchors and an outer surface of the main body;
wherein each ventricular anchor is finger-like and extends from at least one attachment point on the ventricular end portion of the main body and wherein each ventricular anchor is pre-formed to extend along the outer surface of the main body in a functional deployed state;
wherein the prosthetic valve is disposed within a distal end portion of the sheath with main body of the frame retained in the radially compressed state and the ventricular anchors retained in a partially or completely straightened configuration extending distally from the ventricular end portion of the main body, and wherein an atrial end of the main body is releasably attached to the pusher shaft;
wherein the ventricular anchors are configured to be deployed from the sheath while the main body is still retained in the radially compressed state, which allows the ventricular anchors to spring back from the straightened configuration to the functional deployed state, wherein the main body is configured to deployed from the sheath and expand from the radially compressed state to the radially expanded state after the ventricular anchors have been deployed from the sheath;
wherein the delivery apparatus is configured to deliver the prosthetic valve to the native valve in a trans-septal delivery approach in which the delivery apparatus extends through an atrial septum of the heart.
2. The system of claim 1 , wherein the ventricular anchors are pre-formed in a curved shape that extends along the side of the main body on the deployed state.
3. The system of claim 1 , wherein the at least two ventricular anchors comprise six or more ventricular anchors that are spaced around the outside of the main body in the deployed state.
4. The system of claim 1 , wherein each ventricular anchor extends from only one attachment point on the ventricular end portion of the main body.
5. The system of claim 1 , wherein the prosthetic valve further comprises at least one biocompatible layer connected to the inner and/or outer surfaces of the main body.
6. The system of claim 5 , wherein the layer is wrapped around a ventricular end of the main body.
7. The system of claim 1 , wherein each of the ventricular anchors comprises a flexible wire covered by a biocompatible material.
8. The system of claim 1 , wherein the atrial end of the main body comprises locking features for releasable attaching the prosthetic valve to the pusher shaft.
9. A system for replacing a native valve of the heart comprising:
a delivery apparatus comprising a sheath and a pusher shaft extending through the sheath; and
a prosthetic valve comprising:
a frame made of a shape-memory material and comprising a main body having an atrial end, a ventricular end, and a longitudinal axis extending from the atrial end to the ventricular end, the frame further comprising a ventricular anchoring portion at the ventricular end of the main body, the ventricular anchoring portion comprising a plurality of ventricular anchors, each ventricular anchor having a first end that is attached to the main body and a second end that is spaced from the first end and not attached to the main body; and
a valve structure disposed within the main body of the frame;
wherein the prosthetic valve is disposed within a distal end portion of the sheath with the main body of the frame retained in a radially compressed state and the ventricular anchors extending distally from the ventricular end of the main body in a straightened configuration parallel to the longitudinal axis, and wherein the atrial end of the main body is releasably attached to the pusher shaft;
wherein when the prosthetic valve is deployed from the distal end portion of the sheath, the main body of the frame radially expands from the radially compressed state to a radially expanded state and the ventricular anchors transition from the straightened configuration to a deployed configuration alongside the main body of the frame for capturing native leaflets of the native valve between the ventricular anchors and an outer surface of the main body.
10. The system of claim 9 , wherein the ventricular anchors are finger-like.
11. The system of claim 9 , wherein each ventricular anchor extends from only one attachment location on the main body.
12. The system of claim 9 , wherein when the ventricular anchors transition to the deployed configuration, each ventricular anchor has a first end portion and a second end portion, the first end portion extending below the ventricular end of the main body and then curving back upward toward the atrial end of the main body, the second end portion extending from the first end portion in a straight path alongside the main body of the frame.
13. The system of claim 9 , wherein the sheath comprises a primary sheath and the delivery apparatus comprises a secondary sheath disposed within the primary sheath, wherein the secondary sheath extends over the pusher shaft and the main body of the frame but not the ventricular anchors such that when the primary sheath is retracted relative to the prosthetic valve, the ventricular anchors are free to transition from the straightened configuration to the deployed configuration while the main body is retained by the secondary sheath.
14. The system of claim 9 , wherein the valve structure comprises three leaflets made of pericardium coupled to a layer of fabric inside of the main body.
15. The system of claim 9 , wherein the main body comprises a plurality of circumferentially extending rows of angled struts, wherein the first end of each ventricular anchor is attached to the main body at the intersection of two adjacent angled struts in one of the rows.
16. The system of claim 9 , wherein each ventricular anchor is covered by a biocompatible material.
17. A system for replacing a native valve of the heart comprising:
a delivery apparatus comprising a sheath; and
a prosthetic valve comprising:
a frame made of a shape-memory material and comprising a main body having an atrial end, a ventricular end, and a longitudinal axis extending from the atrial end to the ventricular end, the frame further comprising a ventricular anchoring portion at the ventricular end of the main body, the ventricular anchoring portion comprising a plurality of finger-like ventricular anchors, each ventricular anchor having a first end that is attached to the main body and a second end that is spaced from the first end and not attached to the main body; and
a valve structure disposed within the main body of the frame;
wherein the prosthetic valve is disposed within a distal end portion of the sheath with the main body of the frame retained in a radially compressed state and the ventricular anchors extending distally from the ventricular end of the main body in a straightened configuration parallel to the longitudinal axis;
wherein when the prosthetic valve is deployed from the distal end portion of the sheath, the main body of the frame radially expands from the radially compressed state to a radially expanded state and the ventricular anchors transition from the straightened configuration to a deployed configuration alongside the main body of the frame for capturing native leaflets of the native valve between the ventricular anchors and an outer surface of the main body.
18. The system of claim 17 , wherein when the ventricular anchors transition to the deployed configuration, each ventricular anchor has a first end portion and a second end portion, the first end portion extending below the ventricular end of the main body and then curving back upward toward the atrial end of the main body, the second end portion extending from the first end portion in a straight path alongside the main body of the frame.
19. The system of claim of claim 17 , wherein the main body comprises a plurality of circumferentially extending rows of angled struts, wherein the first end of each ventricular anchor is attached to the main body at the intersection of two adjacent angled struts in one of the rows.
20. The system of claim 17 , wherein the frame of the prosthetic valve further comprises an atrial anchoring portion that extends radially outwardly from the main body when the prosthetic valve is deployed from the distal end portion of the sheath.
21. A system for replacing a native valve of the heart comprising:
a delivery apparatus comprising a sheath; and
a prosthetic valve comprising:
a frame made of a shape-memory material and comprising an annular main body and a plurality of ventricular anchors, each ventricular anchor having a first end that is attached to the main body and a second end that is spaced from the first end and not attached to the main body;
an atrial anchor attached to an atrial end portion of the main body; and
a valve structure disposed within the main body of the frame;
wherein the prosthetic valve is disposed within a distal end portion of the sheath in a compressed, delivery state;
wherein when the prosthetic valve is deployed from the distal end portion of the sheath, the main body of the frame radially expands to a radially expanded state, the ventricular anchors expand to a deployed state alongside the main body of the frame for capturing native leaflets of the native valve between the ventricular anchors and an outer surface of the main body, and the atrial anchor expands to a deployed state extending radially outwardly from the main body for contacting an atrial side of the native valve and for preventing blood from flowing between the main body and the native valve.
22. The system of claim 21 , wherein the atrial anchor comprises a plurality of metal struts connected to the main body and a fabric layer extending over at least one side of the metal struts.
23. The system of claim 21 , wherein each ventricular anchor comprises a single wire extending from a single attachment point on the main body.
24. The system of claim 21 , wherein the valve structure comprises three leaflets made of pericardium coupled to a layer of fabric inside of the main body.
25. The system of claim 21 , wherein the delivery apparatus is steerable and is configured to deliver the prosthetic valve to the native valve in a trans-septal delivery approach in which the delivery apparatus extends through an atrial septum of the heart.
26. The system of claim 21 , wherein the delivery apparatus further comprises a pusher shaft releasably attached to the prosthetic valve.