Methods for transluminal delivery of prosthetic valves

• US 8,986,329 B2
• Filed: 10/28/2013
• Issued: 03/24/2015
• Est. Priority Date: 11/17/1999
• Status: Expired due to Fees

• Current Assignee: Medtronic Corevalve LLC (Medtronic Plc)
• Original Assignee: Medtronic Corevalve LLC (Medtronic Plc)
• Inventors: Seguin, Jacques, Bortlein, Georg
• Primary Examiner(s): Isabella, David
• Assistant Examiner(s): SCHILLINGER, ANN M
• Application Number:
  US14/064,979
• Publication Number:
  US 20140121765A1
• Time in Patent Office: 512 Days
• US Class Current: 606/151
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61F 2/013 Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2433 using balloon catheter
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/93 circumferentially expandable by using ratcheting locks
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2002/91591 Locking connectors, e.g. using male-female connections
• CPC Class Codes: A61F 2210/0023 operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• 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 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• 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 2230/0078 : hyperboloidal
• CPC Class Codes: A61F 2250/0003 : having an inflatable pocket filled with fluid, e.g. liquid or gas
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0048 : differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
• CPC Class Codes: A61F 2250/0069 : Sealing means

Abstract

A prosthetic valve assembly for use in replacing a deficient native valve comprises a replacement valve supported on an expandable valve support. 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 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.

Claims

1. A method for implanting a prosthetic cardiac valve comprising:

inserting a prosthetic cardiac valve into a body lumen, the prosthetic cardiac valve comprising;

a replacement valve comprising;

a plurality of leaflets configured to permit blood to selectively flow therethrough; and

a plurality of commissure points from which the replacement valve is suspended; and

a valve support connected to the replacement valve and configured to be collapsible for transluminal delivery, comprising;

a first section terminating in a first end, the first end comprising an outer circumference having a first diameter, the first section configured to engage a native valve annulus; and

a second section terminating in a second end, the second end comprising an outer circumference having a second diameter, the second section configured to extend past the coronary ostia and into the ascending aorta,

wherein the second circumference is greater than the first circumference,

and wherein the valve support has an axial length sufficient to extend, when implanted, from the native valve annulus, past the replacement valve, past the commissure points, past a patient'"'"'s coronary ostia, and into an ascending aorta;

positioning the prosthetic cardiac valve such that the valve support extends from the native annulus past the coronary ostia and into the ascending aorta; and

deploying the prosthetic cardiac valve.

2. The method of claim 1, further comprising loading the prosthetic cardiac valve onto a delivery system.

3. The method of claim 2, further comprising covering the prosthetic cardiac valve with a sheath.

4. The method of claim 3, wherein deploying the prosthetic cardiac valve comprises withdrawing the sheath.

5. The method of claim 2, further comprising advancing the delivery system through the body lumen to an implantation location within the patient'"'"'s heart.

6. The method of claim 1, wherein the valve support comprises a plurality of wires.

7. The method of claim 1, wherein the valve support comprises a shape memory material.

8. The method of claim 1, wherein the valve support is self-expanding.

9. The method of claim 1, wherein deploying the prosthetic cardiac valve comprises expanding the prosthetic cardiac valve to a preset diameter to prevent occlusion of the coronary ostia.

10. A method for implanting a prosthetic cardiac valve comprising:

inserting a prosthetic cardiac valve into a body lumen, the prosthetic cardiac valve comprising;

a collapsible valve support; and

a plurality of leaflets connected to an interior of the valve support,

wherein the valve support has an axial length greater than a length from a patient'"'"'s native valve annulus to the patient'"'"'s coronary ostia;

positioning the prosthetic cardiac valve such that the valve support extends from the native annulus past the coronary ostia and into the patient'"'"'s ascending aorta; and

deploying the prosthetic cardiac valve.

11. The method of claim 10, wherein deploying the prosthetic cardiac valve comprises expanding the prosthetic cardiac valve to a preset diameter to prevent occlusion of the coronary ostia.

12. The method of claim 10, further comprising:

loading the prosthetic cardiac valve onto a delivery system;

covering the prosthetic cardiac valve with a sheath; and

advancing the delivery system through the body lumen to an implantation location within the patient'"'"'s heart.

13. The method of claim 12, wherein deploying the prosthetic cardiac valve further comprises withdrawing the sheath.

14. The method of claim 10, wherein the valve support comprises a plurality of wires.

15. The method of claim 10, wherein the valve support comprises a shape memory material.

16. The method of claim 10, wherein the valve support is self-expanding.

17. The method of claim 10, wherein the prosthetic cardiac valve comprises a first portion having a first cross-sectional area and a second portion having a second cross-sectional area, and wherein the second cross-sectional area is greater than the first cross-sectional area.

18. A method for replacing a native cardiac valve comprising:

loading a prosthetic cardiac valve onto a delivery system, the prosthetic cardiac valve comprising;

a collapsible valve support; and

a plurality of leaflets connected to an interior of the valve support,

wherein the valve support has an axial length greater than a length from a patient'"'"'s native valve annulus to the patient'"'"'s coronary ostia;

covering the prosthetic cardiac valve with a sheath;

inserting the delivery system into a body lumen;

advancing the delivery system through the body lumen to an implantation location within the patient'"'"'s heart;

positioning the prosthetic cardiac valve such that the valve support extends from the native annulus past the coronary ostia and into the patient'"'"'s ascending aorta;

deploying the prosthetic cardiac valve; and

removing the delivery system from the body lumen.

19. The method of claim 18, wherein the deploying the prosthetic cardiac valve comprises expanding the prosthetic cardiac valve to a preset diameter to prevent occlusion of the coronary ostia.

20. The method of claim 18, wherein the valve support is self-expanding.