Leaflet Attachment For Function In Various Shapes and Sizes
A prosthetic heart valve includes a collapsible and expandable stent and a plurality of commissure features disposed on the stent. A collapsible and expandable valve assembly includes a plurality of leaflets connected to the plurality of commissure features, each commissure feature including a body having a proximal end and a distal end. A plurality of eyelets is arranged in rows and columns on the body for distributing load from the plurality of leaflets.
The present application is a continuation of U.S. patent application Ser. No. 13/781,201, filed on Feb. 28, 2013, and claims the benefit of the filing date of U.S. Provisional Patent Application No. 61/666,224 filed Jun. 29, 2012, the disclosures of which are both hereby incorporated by reference herein.
BACKGROUND OF THE INVENTIONThe present invention relates to heart valve replacement and, in particular, to collapsible prosthetic heart valves. More particularly, the present invention relates to collapsible prosthetic heart valves that may be repositioned during a deployment procedure.
Prosthetic heart valves that are collapsible to a relatively small circumferential size can be delivered into a patient less invasively than valves that are not collapsible. For example, a collapsible valve may be delivered into a patient via a tube-like delivery apparatus such as a catheter, a trocar, a laparoscopic instrument, or the like. This collapsibility can avoid the need for a more invasive procedure such as full open-chest, open-heart surgery.
Collapsible prosthetic heart valves typically take the form of a valve structure mounted on a stent. There are two types of stents on which the valve structures are ordinarily mounted: a self-expanding stent and a balloon-expandable stent. To place such valves into a delivery apparatus and ultimately into a patient, the valve must first be collapsed or crimped to reduce its circumferential size.
When a collapsed prosthetic valve has reached the desired implant site in the patient (e.g., at or near the annulus of the patient's heart valve that is to be replaced by the prosthetic valve), the prosthetic valve can be deployed or released from the delivery apparatus and re-expanded to full operating size. For balloon-expandable valves, this generally involves releasing the entire valve, assuring its proper location, and then expanding a balloon positioned within the valve stent. For self-expanding valves, on the other hand, the stent automatically expands as the sheath covering the valve is withdrawn.
In delivery systems for self-expanding aortic valves, after the delivery system has been positioned for deployment, the annulus end of the valve may be unsheathed and expanded first, while the aortic end of the valve remains sheathed. Once the annulus end of the valve has expanded, it may be determined that the valve needs to be repositioned in the patient's aortic annulus. To accomplish this, a user (such as a surgeon or an interventional cardiologist) typically resheaths the annulus end of the valve, so that the valve can be repositioned while in a collapsed state. After the valve has been repositioned, the user can fully deploy the valve.
Once a self-expanding valve has been fully deployed, it expands to a diameter larger than that of the sheath that previously contained the valve in the collapsed condition, making resheathing impossible, or difficult at best. In order for the user to be able to more readily resheath a valve, it is preferable that the position and operation of the valve be evaluated after the valve has been only partially deployed, with a portion of the valve still collapsed inside of the sheath.
Despite the various improvements that have been made to collapsible prosthetic heart valves, conventional devices, suffer from some shortcomings. For example, in certain procedures, collapsible valves may be implanted in a native valve annulus without first resecting the native valve leaflets. The collapsible valves may have critical clinical issues because of the nature of the stenotic leaflets that are left in place. Additionally, patients with uneven calcification, bi-cuspid disease, and/or valve insufficiency could not be treated well, if at all, with the current collapsible designs.
The reliance on evenly calcified leaflets could lead to several problems such as: (1) perivalvular leakage (PV leak), (2) valve migration, (3) mitral valve impingement, (4) conduction system disruption, (5) coronary blockage, etc., all of which can have severely adverse clinical outcomes. To reduce these adverse events, the optimal valve would seal and anchor adequately without the need for excessive radial force, protrusion into the left ventricular outflow tract (LVOT), etc., that could harm nearby anatomy and physiology.
There therefore is a need for further improvements to the devices and systems of collapsible prosthetic heart valves, and in particular, self-expanding prosthetic heart valves. Among other advantages, the present invention may address one or more of these needs.
SUMMARY OF THE INVENTIONIn some embodiments, a prosthetic heart valve includes a collapsible and expandable stent having a proximal end, a distal end, an annulus section adjacent the proximal end and an aortic section adjacent the distal end. The heart valve further includes a plurality of commissure features disposed on the stent and a collapsible and expandable valve assembly, the valve assembly including a plurality of leaflets connected to the plurality of commissure features. Each commissure feature includes a body having a proximal end a distal end, and a plurality of eyelets arranged in at least two rows and at least two columns for distributing load from the plurality of leaflets.
In some examples, each of the plurality of commissure features includes a body that is substantially rectangular. Additionally, each of the plurality of commissure features may include at least three rows of eyelets disposed on the body. Each of the plurality of commissure features may include two columns of eyelets disposed on the body. Each of the plurality of eyelets may be substantially the same shape and/or size.
In some embodiments, a prosthetic valve assembly for assembly to a collapsible and expandable stent includes a stent having a plurality of commissure features, each commissure feature including a body having a longitudinal direction extending between a proximal end and a distal end, and a plurality of eyelets arranged in a plurality of columns each extending in the longitudinal direction, the body having a width in a direction orthogonal to the longitudinal direction. The valve assembly may include a plurality of leaflets, each leaflet having a top free edge for coapting with others of the leaflets and including at least one rectangular tab foldable upon itself along a fold line for attaching to a commissure feature at a leaflet-commissure feature junction, the at least one rectangular tab having a width which is at least as long as the width of the body.
In some examples, the tab includes a distal end extending beyond the distal end of the body when the tab is aligned for attachment to the commissure feature. A flap may be coupled to one side of the tab to provide an additional buffer at the leaflet-commissure feature junction.
In some embodiments a prosthetic heart valve includes a collapsible and expandable stent having a proximal end, a distal end, an annulus section adjacent the proximal end and an aortic section adjacent the distal end. A plurality of commissure features may be disposed on the stent, each commissure feature including a body having a longitudinal direction extending between a proximal end and a distal end, and a plurality of eyelets arranged in at least two columns extending in the longitudinal direction and at least two rows extending in a direction orthogonal to the longitudinal direction, for distributing load from the plurality of leaflets. A collapsible and expandable valve assembly may include a plurality of leaflets connected to the plurality of commissure features via a suture pattern. The plurality of eyelets may be arranged in two columns and the suture pattern forms an “X” pattern between an eyelet in a first of the column and an adjacent eyelet of a second in the columns.
Various embodiments of the present invention are described herein with reference to the drawings, wherein:
Various embodiments of the present invention will now be described with reference to the appended drawings. It is to be appreciated that these drawings depict only some embodiments of the invention and are therefore not to be considered limiting of its scope.
As used herein, the term “proximal,” when used in connection with a prosthetic heart valve, refers to the end of the heart valve closest to the heart when the heart valve is implanted in a patient, whereas the term “distal,” when used in connection with a prosthetic heart valve, refers to the end of the heart valve farthest from the heart when the heart valve is implanted in a patient.
The prosthetic heart valve 100 includes a stent or frame 102, which may be wholly or partly formed of any biocompatible material, such as metals, synthetic polymers, or biopolymers capable of functioning as a stent. Suitable biopolymers include, but are not limited to, elastin, and mixtures or composites thereof. Suitable metals include, but are not limited to, cobalt, titanium, nickel, chromium, stainless steel, and alloys thereof, including nitinol. Suitable synthetic polymers for use as a stent include, but are not limited to, thermoplastics, such as polyolefins, polyesters, polyamides, polysulfones, acrylics, polyacrylonitriles, polyetheretherketone (PEEK), and polyaramides. The stent 102 may have an annulus section 110 an aortic section (not shown) and a transition section (not shown) disposed between the annulus section and the aortic section. Each of the annulus section 110, the transition section and the aortic section of the stent 102 includes a plurality of cells 112 connected to one another around the stent. The annulus section 110 and the aortic section of the stent 102 may include one or more annular rows of cells 112 connected to one another. For instance, the annulus section 110 may have two annular rows of cells 112. When the prosthetic heart valve 100 is in the expanded condition, each cell 112 may be substantially diamond shaped. Regardless of its shape, each cell 112 is formed by a plurality of struts 114. For example, a cell 112 may be formed by four struts 114.
The stent 102 may include commissure features 116 connecting at least two cells 112 in the longitudinal direction of the stent 102. The commissure features 116 may include eyelets for facilitating the suturing of a valve assembly 104 to the sent 102.
The prosthetic heart valve 100 also includes a valve assembly 104 attached inside the annulus section 110 of the stent 102. United States Patent Application Publication No. 2008/0228264, filed Mar. 12, 2007, and United States Patent Application Publication No. 2008/0147179, filed Dec. 19, 2007, the entire disclosures of both of which are hereby incorporated herein by reference, describe suitable valve assemblies. The valve assembly 104 may be wholly or partly formed of any suitable biological material or polymer. Examples of biological materials suitable for the valve assembly 104 include, but are not limited to, porcine or bovine pericardial tissue. Examples of polymers suitable for the valve assembly 104 include, but are not limited to, polyurethane and polyester. In at least some examples, portions of valve assembly 104, a cuff and the suture used may include an ultra high molecular weight polyethylene, such as FORCE FIBER®.
The valve assembly 104 may include a cuff 106 disposed on the lumenal surface of annulus section 110, on the ablumenal surface of annulus section 110, or on both surfaces, and the cuff may cover all or part of either or both of the lumenal and ablumenal surfaces of the annulus section. The cuff 106 and/or the sutures used to attach the valve assembly 104 to stent 102 may be formed from or include ultra-high-molecular-weight polyethylene.
As shown in
As discussed above, the leaflets 108 may be attached directly to and supported by the struts 114a, 114b, 114c, 114d, 114e, and 114f, and by commissure features 116, such as by suturing. In such event, the cuff 106 may perform little or no supportive function for the leaflets 108. Hence, the cuff 106 is not subjected to high stresses and is therefore less likely to wear during use. In light of this, the thickness of the cuff may be reduced. Reducing the thickness of the cuff 106 results in a decrease in the volume of the valve assembly 104 in the collapsed condition. This decreased volume is desirable as it enables the prosthetic heart valve 100 to be implanted in a patient using a delivery device that is smaller in cross-section than conventional delivery devices. In addition, since the material forming the stent struts 114 is stronger than the material forming the cuff 106, the stent struts 114 may perform the supportive function for the leaflets 108 better than the cuff 106.
The volume of the valve assembly 104 may be further reduced by having the cuff 106 cover only a portion of the surface of annulus section 110. With continued reference to
As a result of the foregoing configuration, all of the cells 112 in the bottom annular row 113 of cells may be entirely covered by the cuff 106. The cuff 106 may also entirely cover those cells 112 in the second annular row 115 that are located directly below the commissure features 116. All of the other cells 112 in the stent 102 may be open or not covered by the cuff 106. Hence, there may be no cells 112 which are only partially covered by the cuff 106.
Since the edges of the valve leaflets 108 extend up to the second annular row 115 of cells 112 only in the regions of the commissure features 116, there is little to no likelihood of leakage in the area of the cells between the commissure features in the second annular row of cells, and therefore no need for the cuff 106 to cover this area. This reduction in the area of the cuff 106, both at the proximal end 118 and at the distal end 120 thereof, reduces the amount of material in the valve assembly 104, thereby enabling the prosthetic valve 100 to achieve a smaller cross-section in the collapsed condition.
In operation, the embodiments of the prosthetic heart valve 100 described above may be used to replace a native heart valve, such as the aortic valve, a surgical heart valve or a heart valve that has undergone a surgical procedure. The prosthetic heart valve may be delivered to the desired site (e.g., near a native aortic annulus) using any suitable delivery device. During delivery, the prosthetic heart valve is disposed inside the delivery device in the collapsed condition. The delivery device may be introduced into a patient using a transfemoral, transapical, transseptal, tranxaxillary or other approach. Once the delivery device has reached the target site, the user may deploy the prosthetic heart valve. Upon deployment, the prosthetic heart valve expands into secure engagement within the native aortic annulus. When the prosthetic heart valve is properly positioned inside the heart, it works as a one-way valve, allowing blood to flow in one direction and preventing blood from flowing in the opposite direction.
In certain procedures, collapsible valves may be implanted in a native valve annulus without first resecting the native valve leaflets. The collapsible valves may have critical clinical issues because of the nature of the stenotic leaflets that are left in place. Additionally, patients with uneven calcification, bi-cuspid aortic valve disease, and/or valve insufficiency could not be treated well, if at all, with the current collapsible designs.
The reliance on evenly calcified leaflets could lead to several problems such as: (1) perivalvular leakage (PV leak), (2) valve migration, (3) mitral valve impingement, (4) conduction system disruption, (5) coronary blockage, etc., all of which can have severely adverse clinical outcomes. To reduce these adverse events, the optimal valve would seal and anchor adequately without the need for excessive radial force, protrusion into the left ventricular outflow tract (LVOT), etc., that could harm nearby anatomy and physiology.
It will be understood that the coaptation of “the free edges” of the valve leaflets does not necessarily mean that the actual edges meet per se. Indeed, the leaflets are preferably sized, shaped, and attached such that a suitable “belly” contour is formed. And the leaflets should each include a portion extending from the free edge toward the annulus (referred to herein as a “coaptation section”) that may engage the coaptation sections of the other leaflets such that there will be a surface area of contact between the leaflets rather than edge-to-edge contact. This surface area of contact is important so that, when in a closed or “coapted” condition, the leaflets cooperate to substantially prevent backflow or regurgitation of blood through the valve. These areas of actual contact between the coaptation sections of adjacent leaflets are referred to herein as the coaptation junctions of the leaflets and are illustrated in
The annulus section of prosthetic heart valve 200 has a generally regular cylindrical shape by which is meant that the structure has a generally circular cross-section with a substantially constant diameter along its length. When placed in the annulus of a native heart valve, such as, for example, the tricuspid aortic valve, and expanded, a substantially fluid-tight fit should result. However, the native valve annulus may not be circular, and, in fact, may vary from patient to patient, as may the shape of the aortic sinus or aorta, the angle of the junction between the valve annulus and the aortic sinus, and other local anatomical features. When prosthetic heart valve 200 is deployed and expanded, it must accommodate these anatomical variations in order to function properly. This may result in a distortion in the shape of stent 202 and/or valve assembly 204, and the repositioning of leaflets 208a, 208b, and 208c relative to one another, which can affect the coaptation junctions 211a, 211b, and 211c.
As the stent of a collapsible prosthetic heart valve distorts during implantation, during beating of the heart, or because of irregularities in the patient's anatomy or the condition of the native valve, such distortion may be translated to the valve assembly, such that not all of the valve leaflets meet to form effective coaptation junctions. This can result in leakage or regurgitation and other inefficiencies which can reduce cardiac performance. Moreover, if the prosthetic valve is not placed optimally and the valve leaflets are not coapting as intended, other long term effects, such as uneven wear of the individual leaflets, can be postulated.
As shown in
In addition to inadequate coaptation, less than ideal native valve geometry may also increase the stresses on certain portions of the prosthetic heart valve.
Features of this aspect of the present invention will be described in connection with the commissure features shown in
Another embodiment of commissure feature 600 is depicted in
In another embodiment of commissure feature 600, illustrated in
The commissure feature 600 of
A commissure feature 600 with a slightly shorter body 602 is illustrated in
As seen in
Two square-shaped bodies 602 may be connected to form a commissure feature 600 as seen in
Although the commissure features have been described herein as having three or four row of eyelets, any number of rows and/or columns of eyelets may be used, each row and/or column having any number of eyelets. Preferably, the commissure features have at least two rows of eyelets, more preferably at least three rows of eyelets, with at least two eyelets in each row (in other words, at least two columns of eyelets). Moreover, the shapes and sizes of the eyelets in one or more rows may be the same as or different from the shapes and sizes of the eyelets in the other rows. Preferably, however, the shapes and sizes of the eyelets within each row are substantially the same so that the commissure feature has substantial symmetry with respect to the central longitudinal axis of body 602.
In addition to the improved commissure feature, the leaflets may be constructed to yield improved performance. For example, the size, shape and curvature of the leaflets may be chosen to correspond to the commissure feature to which the leaflets will be attached.
As seen in
The size and shape of the free edge of the valve leaflets may also be modified to further improve performance. As seen in
In addition to modifying the commissure feature and the leaflet configuration, the suture pattern attaching the leaflets to the commissure features may also be modified to improve performance. One example of a modified suture pattern according to the present invention is illustrated in
As seen in
As seen in
The use of a single suture to attach two leaflets 850 to a commissure feature 600 will be described with reference to
The suture pattern may begin at any point at or near commissure feature 600 and terminate at any other point. In at least some examples, the suture pattern begins and terminates at the same position. For the sake of illustration, the suture pattern will be described as beginning at point P1, within eyelet 604b. As used herein, with reference to
The suture pattern S may begin by passing suture S out through eyelet 604b at point p1. Suture S may then be advanced in through point p2 in eyelet 604d, back out through point p3 in eyelet 604b, and finally in through point p4 in eyelet 604d, essentially forming two loops of suture S around rib 651. Suture S may then be directed up toward eyelet 604f and passed out through point p5 in eyelet 604f adjacent central spine 655, and then in through point p6 in eyelet 604e adjacent the opposite side of the central spine subsequently, suture S may be passed out through point p7 in eyelet 604c in through point p8 in eyelet 604a, back out through point p9 in eyelet 604c, and back in through point p10 in eyelet 604a, essentially forming two loops of sutures around rib 657. Suture S may then be directed down toward elongated eyelet 606 and passed out through point p11 in eyelet 606, over the side edge of body 602 at point p12 positioned within recess 608, back out through point p13 in eyelet 606, in through point p14 in the same eyelet, around the side edge of body 602 at point p15 within the second recess 608, and in through point p16 in eyelet 606. The tail (not shown) of suture S at point p16 may then be knotted, tied or otherwise joined to the tail (not shown) of the suture at point p1 to complete the attachment of commissure feature 600.
As seen in
Another example of a suture pattern according to the present invention is illustrated in
As seen in
As seen in
Another example a suture pattern according to the present invention is illustrated in
The pattern of suture S illustrated in
A suture pattern according to the present invention disposed on a commissure feature 600 having only six eyelets is illustrated in
The suture pattern, shown in
Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims. It will be appreciated that the various dependent claims and the features set forth therein can be combined in different ways than presented in the initial claims. It will also be appreciated that the features described in connection with individual embodiments may be shared with others of the described embodiments.
Claims
1. A prosthetic heart valve, comprising:
- a collapsible and expandable stent having an inflow end and an outflow end, the stent including a plurality of struts defining a plurality of cells;
- a plurality of commissure attachment features disposed on the stent, each commissure attachment feature having a first end, a second end opposite the first end, and a plurality of eyelets arranged in at least one column, the first end being connected to first and second struts of one of the plurality of cells, and the second end being connected to third and fourth struts of another one of the plurality of cells, wherein the first and third struts connected to each commissure attachment feature are connected at points that longitudinally align with one another, and the second and fourth struts connected to each commissure attachment feature are connected at points that longitudinally align with one another; and
- a collapsible and expandable valve assembly including a plurality of leaflets connected to the plurality of commissure attachment features.
2. The prosthetic heart valve of claim 1, wherein each commissure attachment feature has a central longitudinal axis and at least three rows of eyelets, each of the at least three rows of eyelets being symmetrical about the central longitudinal axis.
3. The prosthetic heart valve of claim 2, wherein the eyelets of each commissure attachment feature are arranged in a single column.
4. The prosthetic heart valve of claim 1, wherein the eyelets of each commissure attachment feature are aligned along a central longitudinal axis of the commissure attachment feature.
5. The prosthetic heart valve of claim 1, wherein the eyelets of each commissure attachment feature are arranged in three rows.
6. The prosthetic heart valve of claim 1, wherein the eyelets of each commissure attachment feature have the same shape and size as one another.
7. The prosthetic heart valve of claim 1, wherein each commissure attachment feature includes a single body.
8. The prosthetic heart valve of claim 1, wherein each commissure attachment feature includes multiple bodies.
9. The prosthetic heart valve of claim 8, wherein the multiple bodies are longitudinally aligned with one another.
10. The prosthetic heart valve of claim 1, wherein adjacent rows of eyelets are equally spaced from one another.
11. The prosthetic heart valve of claim 1, wherein, when the stent is in an expanded condition, the inflow end of the stent has a first diameter and the outflow end of the stent has a second diameter greater than the first diameter.
12. The prosthetic heart valve of claim 11, wherein a portion of the stent nearer the inflow end is cylindrical when the stent is in the expanded condition.
13. The prosthetic heart valve of claim 12, wherein each commissure attachment feature is disposed at least partially on the cylindrical portion of the stent.
14. The prosthetic heart valve of claim 1, wherein the stent is cylindrical when in a collapsed condition.
15. The prosthetic heart valve of claim 1, wherein the cell having the first and second struts is longitudinally adjacent to the cell having the third and fourth struts.
16. The prosthetic heart valve of claim 15, wherein the first and third struts partially define a first of the plurality of cells, and the second and fourth struts partially define a second of the plurality of cells circumferentially adjacent to the first cell.
17. A prosthetic heart valve, comprising:
- a collapsible and expandable stent having an inflow end and an outflow end, the stent including a plurality of struts defining a plurality of cells, the plurality of cells including at least first and second circumferential annular rows of cells, the second circumferential row being spaced apart from the inflow end;
- a plurality of commissure attachment features disposed on the stent adjacent the second annular row of cells, each commissure attachment feature having a first end, a second end opposite the first end, and a plurality of eyelets arranged in at least one column, the first end being connected to first and second struts of one of the plurality of cells of the second annular row; and
- a collapsible and expandable valve assembly including a plurality of leaflets connected to the plurality of commissure attachment features.
18. The prosthetic heart valve of claim 17, wherein each commissure attachment feature has a central longitudinal axis and at least three rows of eyelets, each of the at least three rows of eyelets being symmetrical about the central longitudinal axis.
19. The prosthetic heart valve of claim 17, wherein the valve assembly spans at least the first and second circumferential annular rows of cells.
20. The prosthetic heart valve of claim 19, wherein the valve assembly further includes a cuff covering at least a portion of the first and second circumferential annular rows of cells.
21. A prosthetic heart valve, comprising:
- a collapsible and expandable stent having an inflow end and an outflow end, the stent including a plurality of struts defining a plurality of cells;
- a plurality of commissure attachment features disposed on the stent, each commissure attachment feature being substantially rectangular with rounded corners and having a first end, a second end opposite the first end, and a plurality of eyelets arranged in at least one column, the first end being connected to first and second struts of one of the plurality of cells, and the second end being connected to third and fourth struts of another one of the plurality of cells; and
- a collapsible and expandable valve assembly including a plurality of leaflets connected to the plurality of commissure attachment features.
22. The prosthetic heart valve of claim 21, wherein each commissure attachment feature has a central longitudinal axis and at least three rows of eyelets, each of the at least three rows of eyelets being symmetrical about the central longitudinal axis.
23. The prosthetic heart valve of claim 22, wherein the eyelets of each commissure attachment feature are arranged in a single column.
24. The prosthetic heart valve of claim 21, wherein the eyelets of each commissure attachment feature have the same shape and size as one another.
25. A prosthetic heart valve, comprising:
- a collapsible and expandable stent having an inflow end and an outflow end, the stent including a plurality of struts defining a plurality of cells, the plurality of cells including at least first and second circumferential annular rows of cells, the second circumferential row being spaced apart from the inflow end;
- a plurality of commissure attachment features disposed on the stent adjacent the second annular row of cells, each commissure attachment feature being substantially rectangular with rounded corners and having a first end, a second end opposite the first end, and a plurality of eyelets arranged in at least one column, the first end being connected to first and second struts of one of the plurality of cells of the second annular row, and the second end being connected to third and fourth struts of another one of the plurality of cells, wherein the first and third struts connected to each commissure attachment feature are connected at points that longitudinally align with one another, and the second and fourth struts connected to each commissure attachment feature are connected at points that longitudinally align with one another; and
- a collapsible and expandable valve assembly including a cuff and a plurality of leaflets connected to the plurality of commissure attachment features, a first end of the cuff substantially following a contour of the inflow end of the stent.
26. The prosthetic heart valve of claim 25, wherein the third and fourth struts are not in the first or second circumferential annular rows of cells.
27. The prosthetic heart valve of claim 25, wherein each commissure attachment feature has a central longitudinal axis and at least three rows of eyelets, each of the at least three rows of eyelets being symmetrical about the central longitudinal axis.
28. The prosthetic heart valve of claim 27, wherein the eyelets of each commissure attachment feature are arranged in a single column.
29. The prosthetic heart valve of claim 25, wherein the eyelets of each commissure attachment feature are aligned along a central longitudinal axis of the commissure attachment feature.
30. The prosthetic heart valve of claim 25, wherein the eyelets of each commissure attachment feature have the same shape and size as one another.
Type: Application
Filed: Aug 12, 2015
Publication Date: Dec 3, 2015
Inventors: Peter N. Braido (Wyoming, MN), Jacob John Daly (Blaine, MN), Julia A. Schraut (Shoreview, MN)
Application Number: 14/824,551