Collapsible-expandable prosthetic heart valves with structures for clamping native tissue
First Claim
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1. A prosthetic heart valve comprising:
- an annular structure having an annular perimeter that is changeable in length between (1) a first relatively small length suitable for delivery of the valve into a patient with reduced invasiveness, and (2) a second relatively large length suitable for use of the annular structure to engage tissue of the patient adjacent to the patient'"'"'s native aortic valve annulus and also in the patient'"'"'s aorta, the annular structure including an annularly continuous annulus portion adapted for implanting adjacent the patient'"'"'s native aortic valve annulus upstream from the ostia of the patient'"'"'s coronary arteries, and an annularly continuous aortic portion adapted for implanting in the patient'"'"'s aorta, the annulus portion and the aortic portion being connected to one another only by a plurality of linking structures, the annulus portion and the aortic portion each including an annular array of diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex aligned with a downstream apex of the downstream apex portion in a longitudinal direction of the annular structure, each of the linking structures having a first end connected directly to the upstream apex of one of the cells in the aortic portion, the first ends being spaced from one another in an annular direction of the aortic portion, and each of the linking structures having a second end connected to the cells in the annulus portion, the second ends being spaced from one another in an annular direction of the annulus portion;
a cuff extending annularly around the annulus portion and having a first annular edge positioned downstream of the upstream apices and a second annular edge positioned upstream of the downstream apices; and
a flexible leaflet structure attached to the annular structure, whereinthe upstream apex portion of each cell in a group of the cells in the annulus portion is resiliently biased to deflect radially outwardly from the connection points, and the downstream apex portion of each cell in the group of the cells is resiliently biased to deflect radially outwardly from the connection points,whereby each cell in the group of the cells, in use, clamps tissue of the patient adjacent to the patient'"'"'s native valve annulus between the upstream apex portion of the cell and the downstream apex portion of the cell, with the upstream apex portion of the cell engaging tissue upstream from the native valve annulus and the downstream apex portion of the cell engaging tissue downstream from the native valve annulus.
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Abstract
A prosthetic heart valve is designed to be circumferentially collapsible for less invasive delivery into the patient. At the implant site the valve re-expands to a larger circumferential size, i.e., the size that it has for operation as a replacement for one of the patient'"'"'s native heart valves. The valve includes structures that, at the implant site, extend radially outwardly to engage tissue structures above and below the native heart valve annulus. These radially outwardly extending structures clamp the native tissue between them and thereby help to anchor the prosthetic valve at the desired location in the patient.
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Citations
15 Claims
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1. A prosthetic heart valve comprising:
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an annular structure having an annular perimeter that is changeable in length between (1) a first relatively small length suitable for delivery of the valve into a patient with reduced invasiveness, and (2) a second relatively large length suitable for use of the annular structure to engage tissue of the patient adjacent to the patient'"'"'s native aortic valve annulus and also in the patient'"'"'s aorta, the annular structure including an annularly continuous annulus portion adapted for implanting adjacent the patient'"'"'s native aortic valve annulus upstream from the ostia of the patient'"'"'s coronary arteries, and an annularly continuous aortic portion adapted for implanting in the patient'"'"'s aorta, the annulus portion and the aortic portion being connected to one another only by a plurality of linking structures, the annulus portion and the aortic portion each including an annular array of diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex aligned with a downstream apex of the downstream apex portion in a longitudinal direction of the annular structure, each of the linking structures having a first end connected directly to the upstream apex of one of the cells in the aortic portion, the first ends being spaced from one another in an annular direction of the aortic portion, and each of the linking structures having a second end connected to the cells in the annulus portion, the second ends being spaced from one another in an annular direction of the annulus portion; a cuff extending annularly around the annulus portion and having a first annular edge positioned downstream of the upstream apices and a second annular edge positioned upstream of the downstream apices; and a flexible leaflet structure attached to the annular structure, wherein the upstream apex portion of each cell in a group of the cells in the annulus portion is resiliently biased to deflect radially outwardly from the connection points, and the downstream apex portion of each cell in the group of the cells is resiliently biased to deflect radially outwardly from the connection points, whereby each cell in the group of the cells, in use, clamps tissue of the patient adjacent to the patient'"'"'s native valve annulus between the upstream apex portion of the cell and the downstream apex portion of the cell, with the upstream apex portion of the cell engaging tissue upstream from the native valve annulus and the downstream apex portion of the cell engaging tissue downstream from the native valve annulus. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A prosthetic heart valve comprising:
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an annularly compressible and expandable annular structure including (1) an annularly continuous annulus inflow portion adapted for implanting adjacent a patient'"'"'s native aortic valve annulus, (2) an annularly continuous aortic outflow portion adapted for implanting in the patient'"'"'s aorta, and (3) a plurality of linking structures connecting the annulus inflow portion to the aortic outflow portion, each of the linking structures having a first end connected directly to the aortic outflow portion, the first ends being spaced from one another in an annular direction around the annular structure, the annulus inflow portion defining a plurality of commissure tips that are spaced from one another in the annular direction, each of the commissure tips having a free end and an associated pair of the linking structures disposed on opposite sides of the commissure tip in the annular direction, the associated pair of linking structures including a first linking structure and a second linking structure, the first linking structure and the second linking structure being spaced apart from one another by a distance in the annular direction that is less than the distance in the annular direction between the first linking structure and a next adjacent linking structure not in the pair such that the second linking structure is not between the first linking structure and the next adjacent linking structure, the annulus portion including an annular array of diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex aligned with a downstream apex of the downstream apex portion in a longitudinal direction of the annular structure; and a flexible leaflet structure attached to the annular structure, wherein the upstream apex portion of each cell in a group of the cells is resiliently biased to deflect radially outwardly from the connection points, and the downstream apex portion of each cell in the group of the cells is resiliently biased to deflect radially outwardly from the connection points, whereby each cell in the group of the cells, in use, clamps tissue of the patient adjacent to the patient'"'"'s native valve annulus between the upstream apex portion of the cell and the downstream apex portion of the cell. - View Dependent Claims (12)
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13. A prosthetic heart valve comprising:
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an annular structure having an annular perimeter that is changeable in length between (1) a first relatively small length suitable for delivery of the valve into a patient with reduced invasiveness, and (2) a second relatively large length suitable for use of the annular structure to engage tissue of the patient adjacent to the patient'"'"'s native aortic valve annulus and also in the patient'"'"'s aorta, the annular structure including an annularly continuous annulus portion adapted for implanting adjacent the patient'"'"'s native aortic valve annulus upstream from the ostia of the patient'"'"'s coronary arteries, an annularly continuous aortic portion adapted for implanting in the patient'"'"'s aorta, and a plurality of commissure post members cantilevered from the annulus portion, the annulus portion and the aortic portion being connected to one another only by a plurality of linking structures, the annulus portion and the aortic portion each including an annular array of diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex aligned with a downstream apex of the downstream apex portion in a longitudinal direction of the annular structure, each of the linking structures having a first end connected directly to the upstream apex of one of the cells in the aortic portion, the first ends being spaced from one another in an annular direction of the aortic portion, and each of the linking structures having a second end connected directly to one of the commissure post members, the second ends being spaced from one another in an annular direction of the annulus portion; a cuff extending annularly around the annulus portion and having a first annular edge positioned downstream of the upstream apices and a second annular edge positioned upstream of the downstream apices; and a flexible leaflet structure attached to the annular structure, wherein the upstream apex portion of each cell in a group of the cells in the annulus portion is resiliently biased to deflect radially outwardly from the connection points, and the downstream apex portion of each cell in the group of the cells is resiliently biased to deflect radially outwardly from the connection points, whereby each cell in the group of the cells, in use, clamps tissue of the patient adjacent to the patient'"'"'s native valve annulus between the upstream apex portion of the cell and the downstream apex portion of the cell, with the upstream apex portion of the cell engaging tissue upstream from the native valve annulus and the downstream apex portion of the cell engaging tissue downstream from the native valve annulus. - View Dependent Claims (14, 15)
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Specification