Stented heart valve devices and methods for atrioventricular valve replacement

• US 20080183273A1
• Filed: 01/17/2008
• Published: 07/31/2008
• Est. Priority Date: 01/19/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Mesana, Thierry, Laske, Timothy G., Ryan, Timothy R., Hill, Alexander J., Tower, Allen
• Granted Patent: US 9,510,943 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2433 using balloon catheter
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/8486 provided on at least one of the ends
• CPC Class Codes: A61F 2210/0014 using shape memory or superelastic materials, e.g. nitinol
• 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 2230/0008 elliptical or oval
• CPC Class Codes: A61F 2230/001 Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61F 2230/0017 Angular shapes
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2250/0018 differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2250/0036 differing in thickness
• CPC Class Codes: A61F 2250/0037 differing in height or in length
• CPC Class Codes: A61F 2250/0039 differing in diameter
• CPC Class Codes: A61F 2250/0064 Sets comprising a plurality of prosthetic parts of different sizes
• CPC Class Codes: A61F 2250/0069 : Sealing means

Abstract

A compressible and expandable stent assembly for implantation in a body lumen such as a mitral valve, the stent assembly including at least one stent barrel that is shaped and sized so that it allows for normal operation of adjacent heart structures. One or more stent barrels can be included in the stent assembly, where one or more of the stent barrels can include a cylinder with a tapered edge.

Claims

1. A compressible and expandable stent assembly for implantation in a body lumen, the stent assembly comprising:

a first stent barrel comprising a tubular structure that is compressible and expandable in a radial direction and that comprises an outer surface having a periphery, wherein a first portion of the periphery of the first stent barrel has a first length and a second portion of the periphery of the first stent barrel has a second length that is less than the first length, and further wherein the first stent barrel comprises a tapered edge that extends from the first portion of the periphery of the first stent barrel to the second portion of the periphery of the first stent barrel; and

a second stent barrel adjacent to and extending from the first stent barrel, wherein the second stent barrel comprises a tubular structure that is compressible and expandable in a radial direction and that comprises an outer surface having a periphery, wherein a first portion of the periphery of the second stent barrel has a first length and a second portion of the periphery of the second stent barrel has a second length that is less than the first length, and further wherein the second stent barrel comprises a tapered edge that extends from the first portion of the periphery of the second stent barrel to the second portion of the periphery of the second stent barrel.

2. The stent assembly of claim 1, wherein the first stent barrel has the same first length, second length, and outer peripheral dimensions as the second stent barrel.

3. The stent assembly of claim 1, wherein the first and second stent barrels extend from each other along a tangential line that extends generally perpendicular to a radial expansion direction of the first and second stent barrels.

4. The stent assembly of claim 1, wherein the first and second stent barrels each comprise a series of wires that are woven together along a tangential line that extends in a generally perpendicular direction to the radial expansion direction of the first and second stent barrels.

5. The stent assembly of claim 1, wherein the first and second stent barrels comprise separate components that are mechanically connected to each other along at least a portion of their lengths for attachment of the first stent barrel to the second stent barrel.

6. The stent assembly of claim 1, wherein a first longitudinal axis extending along the length of the first stent barrel is generally parallel to a second longitudinal axis extending along the length of the second stent barrel.

7. The stent assembly of claim 1, wherein at least one of the first and second stent barrels is cylindrical.

8. The stent assembly of claim 7, wherein the first and second stent barrels have generally the same cross-sectional shape and size.

9. The stent assembly of claim 1, wherein the first stent barrel has a different cross-sectional shape than the second stent barrel.

10. The stent assembly of claim 1, wherein the first stent barrel comprises a first end having at least one flange portion extending at an angle therefrom.

11. The stent assembly of claim 10, wherein the at least one flange portion comprises a series of adjacent structures spaced from each other around at least a portion of the periphery of the first stent barrel at the first end.

12. The stent assembly of claim 10, wherein the second stent barrel comprises a first end having at least one flange portion extending at an angle therefrom.

13. The stent assembly of claim 1, wherein the first and second stent barrels are radially expandable by a balloon catheter.

14. The stent assembly of claim 1, wherein the first and second stent barrels are radially self-expandable.

15. The stent assembly of claim 1, wherein the first stent barrel is offset relative to the second stent barrel in a direction that is parallel to a longitudinal axis of the first and second stent barrels.

16. A compressible and expandable stent assembly for implantation in a body lumen, the stent assembly comprising:

a first stent barrel comprising a first length and a tubular structure that is compressible and expandable in a radial direction; and

a second stent barrel comprising a second length that is less than the first length and a tubular structure that is compressible and expandable in a radial direction, wherein the second stent barrel is adjacent to and extends from the first stent barrel along a tangential line that extends in a generally perpendicular direction to the radial expansion direction of the first and second stent barrels.

17. The stent assembly of claim 16, wherein the tangential line along which the first and second stent barrels extend from each other is generally parallel to a first longitudinal axis and a second longitudinal axis that extend along the lengths of the first and second stent barrels, respectively.

18. A method of positioning a stent assembly into the mitral valve area of a patient, the method comprising the steps of:

providing a stent assembly comprising a first stent barrel having an outer peripheral surface and a first length, and a second stent barrel having an outer peripheral surface that is adjacent to and extending from the outer peripheral surface of the first stent barrel, wherein the second stent barrel has a second length that is greater than the first length; and

positioning the stent assembly in the mitral valve area so that the first stent barrel is adjacent to an anerolateral portion of the mitral valve and the second stent barrel is adjacent to a posteromedial portion of the mitral valve;

wherein the length of the first stent barrel minimizes interference with the functioning of an adjacent aortic valve and provides enough contact area to impede dislodging of the stent assembly.

19. A delivery system for delivering a stent to a body lumen and expanding the stent, the delivery system comprising:

a first axis;

a second axis perpendicular to the first axis;

an expandable central balloon comprising first and second opposite sides and centered on the intersection of the first and second axes;

a first expandable side balloon positioned adjacent to the first side of the central balloon and centered on the first axis; and

a second expandable side balloon positioned adjacent to the second side of the central balloon and centered on the first axis;

wherein a first width of the device measured along the first axis is greater than a second width of the device measured along the second axis.

20. The delivery system of claim 19, wherein the first side balloon, second side balloon, and central balloon are independently inflatable.

21. The delivery system of claim 19, further comprising an outer balloon that encompasses the first side balloon, second side balloon, and central balloon.

22. A compressible and expandable tubular stent comprising a first end, an opposite second end, and a central portion between the first and second ends, wherein the central portion comprises a reinforced area extending around at least a portion of a periphery of the stent.

23. The stent of claim 22, wherein the central portion of the stent is stiffer than the first and second ends of the stent so that the first and second ends of the stent are more radially expandable than the central portion.

24. The stent of claim 22 wherein the stent comprises a series of wires and wherein the wires of at least a portion of the central portion of the stent are thicker than the wires adjacent to the first and second ends of the stent.

25. The stent of claim 22, wherein the central portion includes a sealing gasket.