Valve replacement systems and methods

Abstract

Systems and methods for medical interventional procedures, including approaches to valve implant. In one aspect, the methods and systems involve a modular approach to treatment.

We claim: 
     
         1 . A mitral valve replacement system configured to be implanted to treat a heart having a mitral valve including commissural clefts, at least a posterior leaflet and an anterior leaflet to occlude flow during systole and open flow during diastole, and an annulus, the system comprising:
 an anchoring structure including a supra-annular retention structure and anchoring elements that are configured to engage a sub-annular structure of the mitral valve to position the anchoring structure relative to the mitral valve, the anchoring elements including a plurality of projections extending generally downward from the supra-annular retention structure;   an artificial valve assembly including a frame configured to be received by the supra-annular retention structure and artificial leaflets configured to occlude flow during systole or open flow during diastole; and   wherein the frame of the artificial valve assembly mates with the supra-annular retention structure at a position spaced supra-annularly of the mitral valve annulus.   
     
     
         2 . The mitral valve replacement system of  claim 1 , wherein the anchoring structure is sized and shaped to be implanted at a mitral valve annulus without reshaping the annulus. 
     
     
         3 . The mitral valve replacement system of  claim 1 , wherein the anchoring structure is moveable between a compressed configuration and an expanded configuration. 
     
     
         4 . The mitral valve replacement system of  claim 1 , wherein each of the plurality of projections comprise a looped shape. 
     
     
         5 . The mitral valve replacement system of  claim 1 , wherein the plurality of projections extend downward from the supra-annular retention structure and engage the sub-annular structure of the mitral valve. 
     
     
         6 . The mitral valve replacement system of  claim 5 , wherein each of the plurality of projections comprises a neck portion configured to extend through the commissural clefts and engage the sub-annular structure of the mitral valve. 
     
     
         7 . The mitral valve replacement system of  claim 1 , wherein the plurality of projections comprise webbing configured for tissue ingrowth. 
     
     
         8 . A mitral valve replacement system configured to be implanted to treat a heart having a mitral valve including commissural clefts, at least a posterior leaflet and an anterior leaflet to occlude flow during systole and open flow during diastole, and an annulus, the system comprising:
 an anchoring structure including a supra-annular ring-like structure and anchoring elements that are configured to engage a sub-annular structure of the mitral valve to position the anchoring structure relative to the mitral valve, the anchoring elements including a plurality of projections extending generally downward from the supra-annular ring-like structure;   an artificial valve assembly including a frame configured to be received by the supra-annular ring-like structure and a plurality of artificial leaflets configured to occlude flow or open flow; and   wherein the frame of the artificial valve assembly mates with the supra-annular retention structure at a position spaced supra-annularly of the mitral valve annulus.   
     
     
         9 . The mitral valve replacement system of  claim 8 , wherein the anchoring structure is sized and shaped to be implanted at a mitral valve annulus without reshaping the annulus. 
     
     
         10 . The mitral valve replacement system of  claim 8 , wherein the anchoring structure is moveable between a compressed configuration and an expanded configuration. 
     
     
         11 . The mitral valve replacement system of  claim 8 , wherein each of the plurality of projections comprise a loop shape. 
     
     
         12 . The mitral valve replacement system of  claim 8 , wherein each of the plurality of projections comprises a neck portion configured to extend through the commissural clefts and engage the sub-annular structure of the mitral valve. 
     
     
         13 . A mitral valve replacement system configured to be implanted to treat a heart having a mitral valve including commissural clefts, at least a posterior leaflet and an anterior leaflet to occlude flow during systole and open flow during diastole, and an annulus, the system comprising:
 an anchoring structure including a supra-annular retention structure and anchoring elements that are configured to engage a sub-annular structure of the mitral valve to position the anchoring structure relative to the mitral valve, the anchoring elements including a plurality of projections extending generally downward from the supra-annular retention structure;   an artificial valve assembly including a frame configured to sealingly engage with natural tissue be received by the supra-annular retention anchoring structure; and   wherein the frame of the artificial valve assembly mates with the supra-annular retention structure at a position spaced supra-annularly of the mitral valve annulus.   
     
     
         14 . The mitral valve replacement system of  claim 13 , wherein the anchoring structure is sized and shaped to be implanted at a mitral valve annulus without reshaping the annulus. 
     
     
         15 . The mitral valve replacement system of  claim 13 , wherein the anchoring structure is moveable between a compressed configuration and an expanded configuration. 
     
     
         16 . The mitral valve replacement system of  claim 13 , wherein each of the plurality of projections have a looped shape. 
     
     
         17 . The mitral valve replacement system of  claim 13 , wherein the plurality of projections extend from the supra-annular retention structure and engage the sub-annular structure of the mitral valve. 
     
     
         18 . The mitral valve replacement system of  claim 13 , wherein the artificial valve is configured to sealingly engage with a native leaflet. 
     
     
         19 . The mitral valve replacement system of  claim 18 , wherein sealed engagement is created without reshaping the annulus.