Mitral Valve Prosthesis and Methods for Implantation

Abstract

Apparatus and methods are provided including a mitral valve prosthesis. The prosthesis includes an inner support structure having downstream and upstream sections, the upstream section having a cross-sectional area greater than the downstream section. The inner support structure is configured to be positioned on an atrial side of the native valve complex, and to prevent the prosthesis from being dislodged into the left ventricle. A prosthetic valve having prosthetic valve leaflets is coupled to the inner support structure. An outer support structure has engagement arms, downstream ends of the engagement arms being coupled to the inner support structure. The prosthesis is configured such that, upon implantation thereof:downstream ends of the native valve leaflets,downstream ends of the engagement arms, anddownstream ends of the prosthetic leaflets,are disposed at a longitudinal distance from one another of less than 3 mm. Other embodiments are also described.

1 - 40 . (canceled) 
     
     
         41 . A heart valve prosthesis comprising:
 a frame having a radially compressed configuration and a radially expanded configuration, the frame comprising:
 an first support structure having a radially compressed configuration and a radially expanded configuration; and 
 a second support structure including a plurality of engagement arms, the plurality of engagement arms extending in an upstream direction and configured to be placed over native valve leaflets of a native valve; and 
   a valve structure attached the second support structure.   
     
     
         42 . The heart valve prosthesis of  claim 41 , wherein the valve structure comprises prosthetic valve leaflets. 
     
     
         43 . The heart valve prosthesis of  claim 42 , wherein the prosthetic valve leaflets comprise three prosthetic valve leaflets. 
     
     
         44 . The heart valve prosthesis of  claim 41 , wherein the prosthetic valve leaflets comprise bovine pericardium tissue. 
     
     
         45 . The heart valve prosthesis of  claim 41 , wherein the first support structure is an inner support structure and the second support structure is an inner support structure. 
     
     
         46 . The heart valve prosthesis of  claim 42 , wherein downstream ends of the engagement arms are configured to be within 1 mm of a downstream end of native valve leaflets of a native mitral valve when the heart valve prosthesis is deployed at the native mitral valve. 
     
     
         47 . The heart valve prosthesis of  claim 46 , wherein a downstream end of the first support structure is spaced between 2 mm and 15 mm from downstream ends of the prosthetic valve leaflets. 
     
     
         48 . The heart valve prosthesis of  claim 47 , wherein the downstream end of the first support structure is upstream of the downstream ends of the prosthetic valve leaflets. 
     
     
         49 . The heart valve prosthesis of  claim 41 , wherein an upstream section of the frame curves outwardly from a central longitudinal axis of the heart valve prosthesis. 
     
     
         50 . The heart valve prosthesis of  claim 49 , wherein the upstream section has a greater cross-sectional dimension than a downstream section of the frame. 
     
     
         51 . The heart valve prosthesis of  claim 50 , wherein in the radially expanded configuration, the upstream section is D-shaped. 
     
     
         52 . The heart valve prosthesis of  claim 42 , wherein the second support structure includes commissure posts, wherein the prosthetic valve leaflets are attached to the commissure posts. 
     
     
         53 . The heart valve prosthesis of  claim 52 , wherein the engagement arms are coupled to the commissure posts.