Aortic valve stent graft

• US 10,105,218 B2
• Filed: 11/02/2011
• Issued: 10/23/2018
• Est. Priority Date: 11/09/2007
• Status: Active Grant

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Inventors: Chuter, Timothy A M
• Primary Examiner(s): Prone, Christopher D
• Application Number:
  US13/287,690
• Publication Number:
  US 20120046726A1
• Time in Patent Office: 2,547 Days
• Field of Search: 623 116, 623 124, 623 131, 623 21, 623 238
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/005 using adhesives
• CPC Class Codes: A61F 2220/0058 soldered or brazed or welded
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61F 2250/0007 for adjusting length
• CPC Class Codes: A61F 2250/0048 differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
• CPC Class Codes: A61F 2250/006 modular

Abstract

An implantable endoluminal prosthesis for replacing a damaged aortic valve is provided. In one embodiment, the prosthesis includes a balloon-expandable stent, a tubular conduit that extends into the ascending aorta, and a self-expanding stent. The tubular conduit extends across the balloon-expandable stent. The tubular conduit includes an artificial valve. The self-expanding stent extends across the tubular conduit into the ascending aorta. The balloon-expandable stent, the tubular conduit, and the self-expanding stent are coupled to provide unidirectional flow of fluid into the aorta and further into the coronary arteries. Also provided is a method for implanting the endoluminal prosthesis.

Claims

1. An endoluminal prosthesis having an inflow end and an outflow end that is downstream of the inflow end, the prosthesis comprising:

at least one stent; and

a tubular conduit comprising an aortic valve replacement that allows fluid to pass in an upstream to downstream direction, wherein at least a portion of the tubular conduit overlaps at least a portion of the at least one stent,

wherein an outflow end of the tubular conduit terminates at a location between an upstream proximal end and a downstream distal end of the at least one stent, and

wherein the at least one stent comprises at least one uncovered region downstream of the valve to allow fluid to pass radially outside of an outer perimeter of the at least one stent after passing through the aortic valve replacement,

wherein the at least one stent comprises a proximal zone having a cylindrical shape with a length of a uniform first diameter and a distal zone having a second diameter, where the proximal zone is upstream of the distal zone, where the first diameter is narrower than the second diameter, and there is a taper between the first and second diameters,

wherein the taper of the at least one stent is positioned at least partially downstream of the aortic valve replacement,

wherein all of the aortic valve replacement is distal of the length of the uniform first diameter of the proximal zone, and

wherein an exterior diameter of a terminal distal end of the endoluminal prosthesis is greater than the uniform first diameter of the proximal zone.

2. The endoluminal prosthesis of claim 1, wherein the at least one stent at least partially surrounds the tubular conduit.

3. The endoluminal prosthesis of claim 1, wherein the at least one stent comprises a balloon-expandable stent.

4. The endoluminal prosthesis of claim 1, wherein the at least one stent comprises a self-expanding stent.

5. The endoluminal prosthesis of claim 1, wherein the aortic valve replacement comprises an artificial valve.

6. The endoluminal prosthesis of claim 1, wherein the aortic valve replacement is located at the distal end of the tubular conduit.

7. The endoluminal prosthesis of claim 1 further comprising one or more barbs.

8. An endoluminal prosthesis having an inflow end and an outflow end that is downstream of the inflow end, the prosthesis comprising:

at least one stent; and

a tubular conduit comprising an aortic valve replacement that allows fluid to pass in an upstream to downstream direction, wherein at least a portion of the tubular conduit overlaps at least a portion of an outer surface of the at least one stent,

wherein an outflow end of the tubular conduit terminates at a location between an upstream proximal end and a downstream distal end of the at least one stent, and

wherein the at least one stent comprises a proximal zone having a cylindrical shape with a length of a uniform first diameter and a distal zone having a second diameter, where the proximal zone is upstream of the distal zone, and where the first diameter is narrower than the second diameter, and there is a taper between the first and second diameters,

wherein the taper of the at least one stent is positioned at least partially downstream of the aortic valve replacement,

wherein all of the aortic valve replacement is distal of the length of the uniform first diameter of the proximal zone, and

wherein an exterior diameter of a terminal distal end of the endoluminal prosthesis is greater than an exterior diameter of the endoluminal prosthesis at the aortic valve replacement.

9. The endoluminal prosthesis of claim 8, wherein the at least one stent comprises a balloon-expandable stent.

10. The endoluminal prosthesis of claim 8, wherein the at least one stent comprises a self-expanding stent.

11. The endoluminal prosthesis of claim 8, wherein the aortic valve replacement comprises an artificial valve.

12. The endoluminal prosthesis of claim 8, wherein the aortic valve replacement is located at the distal end of the tubular conduit.

13. The endoluminal prosthesis of claim 8 further comprising one or more barbs.

14. The endoluminal prosthesis of claim 8, wherein the smallest uniform diameter of the endoluminal prosthesis is located at a terminal proximal end of the endoluminal prosthesis.

15. A method of replacing an aortic valve in a subject, the method comprising:

introducing into a vascular system an endoluminal prosthesis having an inflow end and an outflow end that is downstream of the inflow end, the prosthesis comprising at least one stent and a tubular conduit comprising an aortic valve replacement, wherein at least a portion of the tubular conduit overlaps at least a portion of the at least one stent;

advancing the endoluminal prosthesis within the vascular system towards an aortic annulus;

expanding at least a portion of the prosthesis into engagement with the aortic annulus; and

allowing fluid to pass radially outside of an outer perimeter of the at least one stent after passing through the aortic valve replacement in an upstream to downstream direction,

wherein the at least one stent comprises a proximal zone having a cylindrical shape with a length of a uniform first diameter and a distal zone having a second diameter, where the proximal zone is upstream of the distal zone, and where the first diameter is narrower than the second diameter, and there is a taper between the first and second diameters,

wherein the taper of the at least one stent is positioned at least partially downstream of the aortic valve replacement,

wherein the aortic valve replacement is distal of the length of the uniform first diameter of the proximal zone, and

wherein an exterior diameter of a terminal distal end of the endoluminal prosthesis is greater than the uniform first diameter of the proximal.

16. The method of claim 15, wherein the at least one stent at least partially surrounds the tubular conduit.

17. The method of claim 15, wherein the at least one stent comprises a balloon-expandable stent.

18. The method of claim 15, wherein the at least one stent comprises a self-expanding stent.

19. The method of claim 15, wherein the at least one stent and the tubular conduit are provided for unidirectionally passing fluid through the prosthesis and at least inhibiting retrograde flow through the prosthesis.

20. The method of claim 15 further comprising expanding the at least one stent into engagement with at least one of the aortic annulus and the ascending aorta.