Prosthetic Valve for Transluminal Delivery
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Accused Products
Abstract
A prosthetic valve assembly for use in replacing a deficient native valve comprises a replacement valve supported on an expandable valve support. If desired, one or more anchors may be used. The valve support, which entirely supports the valve annulus, valve leaflets, and valve commissure points, is configured to be collapsible for transluminal delivery and expandable to contact the anatomical annulus of the native valve when the assembly is properly positioned. Portions of the valve support may expand to a preset diameter to maintain coaptivity of the replacement valve and to prevent occlusion of the coronary ostia. A radial restraint, comprising a wire, thread or cuff, may be used to ensure expansion does not exceed the preset diameter. The valve support may optionally comprise a drug elution component. The anchor engages the lumen wall when expanded and prevents substantial migration of the valve assembly when positioned in place. The prosthetic valve assembly is compressible about a catheter, and restrained from expanding by an outer sheath. The catheter may be inserted inside a lumen within the body, such as the femoral artery, and delivered to a desired location, such as the heart. A blood pump may be inserted into the catheter to ensure continued blood flow across the implantation site during implantation procedure. When the outer sheath is retracted, the prosthetic valve assembly expands to an expanded position such that the valve and valve support expand at the implantation site and the anchor engages the lumen wall. Insertion of the catheter may optionally be performed over a transseptally delivered guidewire that has been externalized through the arterial vasculature. Such a guidewire provide dual venous and arterial access to the implantation site and allows additional manipulation of the implantation site after arterial implantation of the prosthetic valve. Additional expansion stents may be delivered by venous access to the valve.
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Citations
96 Claims
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1-78. -78. (canceled)
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79. A method for deploying a valve device at the natural aortic valve position at the entrance to the left ventricle of a myocardium of a patient, comprising:
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radially collapsing a deployable implantable valve device having a collapsible and expandable support stent and a collapsible and expandable valve assembly, the support stent comprising a first portion configured to expand to a first diameter and a second portion configured to expand to a second diameter, the first diameter being smaller than the second diameter and wherein the valve assembly is sutured to the support stent; advancing the collapsed valve device through the patient'"'"'s vasculature towards the natural aortic valve position via a catheterization technique; positioning the valve device such that the valve assembly is located substantially within an annulus of a natural aortic valve; and radially expanding the first and second portions such that the first portion engages leaflets of the natural aortic valve and the second portion engages an inner wall of an ascending aorta above the opening of the coronary arteries; wherein, after implantation, the valve assembly allows blood to flow in a first direction and prevents blood from flowing in a second direction and wherein the first and second portions of the support stent are configured to resist migration of the valve assembly; wherein, after implantation, the support stent has a third diameter positioned at the level of the coronary arteries, the third diameter being substantially less than an inner diameter of the ascending aorta such that a radial gap is provided between the support stent and the opening of the coronary arteries. - View Dependent Claims (80, 81, 82, 83, 84)
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86. A method for deploying a valve device at the natural aortic valve position at the entrance to the left ventricle of a myocardium of a patient, comprising:
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radially collapsing an implantable valve device having a collapsible and expandable support stent formed of a shape memory material and a collapsible and expandable valve assembly formed of natural tissue, the support stent comprising a lower portion configured to expand to a first diameter and an upper portion configured to expand to a second diameter, the first diameter being smaller than the second diameter and wherein the valve assembly is sutured to the support stent at an inlet end and is sutured to the support stent along three commissural points for supporting three valve leaflets; advancing the collapsed valve device around the aortic arch to the natural aortic valve position via a catheterization technique; positioning the valve device such that the valve assembly is located within an annulus of a natural aortic valve; and radially expanding the support stent such that the lower portion engages leaflets of the natural aortic valve and the upper portion engages an inner wall of an ascending aorta; wherein, after implantation, the valve assembly allows blood to flow in a first direction and prevents blood from flowing in a second direction and wherein the lower and upper portions of the support stent are configured to resist migration of the valve assembly; wherein the support stent further comprises a central portion between the lower and upper portion, the central portion being shaped to provide a radial gap between the support stent and the inner wall of the ascending aorta at the openings of the coronary arteries. - View Dependent Claims (87)
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88. A method for deploying a valve device at the natural aortic valve position of a patient, comprising:
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radially contracting a deployable implantable valve device having a contractible and radially deployable support and a contractible and radially deployable valve, the support comprising a first portion configured to expand to a first diameter and a second portion configured to expand to a second diameter, the first diameter being smaller than the second diameter and wherein the valve is sutured to the support; advancing the radially contracted valve device through the patient'"'"'s vasculature towards the natural aortic valve position via a catheterization technique; positioning the valve device such that the valve is located substantially within an annulus of a natural aortic valve; and radially deploying the first and second portions of the support such that the first portion engages leaflets of the natural aortic valve and the second portion engages an inner wall of an ascending aorta above the opening of the coronary arteries; wherein, after implantation, the valve allows blood to flow in a first direction and prevents blood from flowing in a second direction and wherein the first and second portions of the support are configured to anchor the valve device; wherein, after implantation, the support has a third diameter positioned at the level of the coronary arteries, the third diameter being substantially less than an inner diameter of the ascending aorta such that a radial gap is provided between the support and the opening of the coronary arteries. - View Dependent Claims (89, 90, 91, 92, 93, 94)
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95. A method for deploying a valve device at the natural aortic valve position of a patient, comprising:
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radially contracting an implantable valve device having a radially contractible and deployable support formed of a shape memory material and a radially contractible and deployable valve formed of biological tissue, the support comprising a lower portion configured to deploy to a first diameter and an upper portion configured to deploy to a second diameter, the first diameter being smaller than the second diameter and wherein the valve is sutured to the support at an inlet end and is sutured to the support along three commissural points for supporting three valve leaflets; advancing the contracted valve device around the aortic arch to the natural aortic valve position via a catheterization technique; positioning the valve device such that the valve is located within an annulus of a natural aortic valve; and radially deploying the support such that the lower portion engages leaflets of the natural aortic valve and the upper portion engages an inner wall of an ascending aorta; wherein, after implantation, the valve allows blood to flow in a first direction and prevents blood from flowing in a second direction and wherein the lower and upper portions of the support are configured to anchor the valve assembly; wherein the support stent further comprises a central portion between the lower and upper portion, the central portion being shaped to provide a radial gap between the support stent and the inner wall of the ascending aorta at the openings of the coronary arteries. - View Dependent Claims (96)
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Specification