Stent assemblies including passages to provide blood flow to coronary arteries and methods of delivering and deploying such stent assemblies

Abstract

An anchor stent assembly to be used with a valve component includes a generally tubular frame having a first end and a second end, the frame defining a central passage and a central axis. A secondary passage is defined between n inner surface of the frame and an outer surface of an inner rib disposed closer to the central axis than the frame. An extension tube is disposed through the secondary passage. The extension tube includes an extension tube lumen having a first opening at a first end of the extension tube and a second opening at a second end of the extension tube.

What is claimed is: 
     
         1 . A stent assembly having a radially compressed delivery configuration and a radially expanded deployed configuration, the stent assembly comprising:
 a generally tubular frame having a first end and a second end, the frame defining a central passage and a central axis;   a secondary passage, defined between an inner surface of the frame and an outer surface of an inner rib closer to the central axis than the frame; and   an extension tube extending through the secondary passage, the extension tube including an extension tube lumen having a first opening at a first end of the extension tube and a second opening at a second end of the extension tube.   
     
     
         2 . The stent assembly of  claim 1 , wherein the stent assembly is configured to be deployed within an aorta adjacent to the aortic sinuses. 
     
     
         3 . The stent assembly of  claim 2 , wherein the secondary passage is aligned parallel with the central axis of the frame. 
     
     
         4 . The stent assembly of  claim 2 , wherein the secondary passage comprises two passages, and the extension tube comprises two extension tubes, with each extension tube extending through a corresponding one of the secondary passages. 
     
     
         5 . The stent assembly of  claim 2 , wherein the extension tube is configured such that the extension tube aligns circumferentially with, but does not obstruct, an ostium of a coronary artery. 
     
     
         6 . The stent assembly of  claim 2 , wherein the extension tube is configured to receive a coronary stent. 
     
     
         7 . The stent assembly of  claim 6 , wherein the extension tube is configured such that a first portion of the coronary stent is disposed within the extension tube and a second portion of the coronary stent extends into the coronary artery. 
     
     
         8 . The stent assembly of  claim 6 , wherein when the stent assembly and the coronary stent are in their second, radially expanded deployed configuration, the extension tube is in fluid communication with the coronary stent and the coronary stent is in fluid communication with the coronary artery. 
     
     
         9 . A method of implanting a stent assembly at a location in an aorta comprising the steps of:
 advancing the stent assembly in a radially compressed delivery configuration to the location in the aorta, wherein the stent assembly comprises a generally tubular frame having a first end and a second end, a central passage, a central axis, a secondary passage formed between an inner surface of the frame and an outer surface of an inner rib closer to the central axis than the frame, and an extension tube extending through the secondary passage, the extension tube being coupled to the frame and having an extension tube lumen;   rotationally orienting the stent assembly such that the extension tube generally circumferentially aligned with an ostium of a coronary artery;   deploying the stent assembly from the radially compressed delivery configuration to a radially expanded deployed configuration at the location within the aorta;   advancing a coronary stent in a radially compressed delivery configuration through the extension tube lumen such that a first portion of the coronary stent resides within the extension tube lumen and a second portion of the coronary stent extends into the coronary artery; and   deploying the coronary stent assembly from the radially compressed delivery configuration to a radially expanded deployed configuration.   
     
     
         10 . The method of  claim 9 , further comprising the steps of:
 delivering a valve component in a radially compressed delivery configuration to a location within a native aortic valve; and   deploying the valve component such that the valve component expands from the radially compressed delivery configuration to a radially expanded configuration.   
     
     
         11 . The method of  claim 9 , wherein the secondary passage of the stent assembly comprises two secondary passages and the extension tube comprises two extensions tubes disposed within a respective one of the two secondary passages, wherein the step of rotationally orienting the stent assembly comprises circumferentially aligning one of the extension tubes with the ostium of the left coronary artery and circumferentially aligning the other of the two extension tubes with the right coronary artery. 
     
     
         12 . A stent assembly having a radially compressed delivery configuration and a radially expanded deployed configuration, the stent assembly comprising:
 a generally tubular frame having a first end and a second end, the frame defining a central passage and a central axis;   a secondary passage, defined between an inner surface of the frame and an outer surface of an inner rib closer to the central axis than the frame;   a proximal alignment arm, wherein the proximal alignment arm is coupled to the frame at the first end of the frame; and   a skirt coupled to the inner rib and the proximal alignment arm such that a coronary channel is defined between an outer surface of the skirt and the frame.   
     
     
         13 . The stent assembly of  claim 12 , wherein the stent assembly is configured to be deployed within an aorta with the proximal alignment arm deployed in a sinus of an aortic valve. 
     
     
         14 . The stent assembly of  claim 13 , wherein the secondary passage is generally parallel with the central axis of the frame. 
     
     
         15 . The stent assembly of  claim 13 , wherein the secondary passage comprises two secondary passages. 
     
     
         16 . The stent assembly of  claim 13 , wherein the proximal alignment arm extends from a proximal end of the frame, the proximal alignment arm configured to be deployed in an aortic sinus, the proximal alignment arm further configured such that a proximal end of the proximal alignment arm extends below an ostium of a coronary artery. 
     
     
         17 . The stent assembly of  claim 13 , wherein the proximal alignment arm comprises two proximal alignment arms. 
     
     
         18 . The stent assembly of  claim 13 , wherein the coronary channel is configured to rotationally align with an ostium of the coronary artery. 
     
     
         19 . The stent assembly of  claim 13 , wherein with the stent assembly deployed in the aorta, the proximal alignment arm encircles an ostium of a coronary artery, and a coronary pocket is defined between the outer surface of the skirt and the aortic sinus in which the proximal alignment arm is disposed. 
     
     
         20 . The stent assembly of  claim 19 , wherein when in the radially expanded deployed configuration, the coronary channel is in fluid communication with the coronary pocket and the coronary pocket is in fluid communication with the coronary artery. 
     
     
         21 . A method of implanting a stent assembly at a location of an aorta comprising the steps of:
 advancing the stent assembly in a radially compressed delivery configuration to the location of the aorta, wherein the stent assembly includes a frame with a central passage and a central axis, a secondary passage formed between an inner surface of the frame and an outer surface of an inner rib closer to the central passage, a proximal alignment arm extending proximally from a proximal end of the frame, and a skirt coupled to the inner rib and the proximal alignment arm;   rotationally orienting the stent assembly such that the secondary channel is generally circumferentially aligned with an ostium of a coronary artery; and   deploying the stent assembly from the radially compressed delivery configuration to a radially expanded deployed configuration at the location within the aorta such that the proximal alignment arm extends into an aortic sinus below the ostium of the coronary artery and a coronary channel is formed between an outer surface of the skirt at the inner ribs and an inner surface of aorta, and a coronary pocket is formed between the outer surface of the skirt at the proximal alignment arm and an inner surface of the aortic sinus.   
     
     
         22 . The method of  claim 21 , further comprising the steps of:
 delivering a valve component in a radially compressed delivery configuration to a location within a native aortic valve; and   deploying the valve component such that the valve component expands from the radially compressed delivery configuration to a radially expanded deployed configuration.   
     
     
         23 . The method of  claim 21 , wherein the secondary passage comprises two secondary passages, and wherein the step of rotationally orienting the stent assembly comprises circumferentially aligning one of the secondary passages with the ostium of the left coronary artery and circumferentially aligning the other of the secondary passages with the right coronary artery. 
     
     
         24 . A valve assembly having a radially compressed delivery configuration and a radially expanded deployed configuration, the valve assembly comprising:
 a generally tubular frame having a first end and a second end, the frame defining a central passage and a central axis:   a prosthetic valve coupled to the frame;   a coronary orifice extending between an inner surface and an outer surface of the frame; and   a coronary arm having a generally tubular structure, the coronary arm defining a longitudinal passage with a longitudinal axis, a first end of the coronary arm coupled to the coronary orifice, the coronary arm having a longitudinally collapsed delivery configuration wherein a second end of the coronary arm is adjacent the first end, and a longitudinally extended deployed configuration wherein the second end is spaced from the first end.   
     
     
         25 . The valve assembly of  claim 24 , wherein the valve assembly is configured to be deployed at a native aortic valve. 
     
     
         26 . The valve assembly of  claim 25 , wherein the longitudinal axis of the coronary arm extends generally transverse to the central axis of the frame. 
     
     
         27 . The valve assembly of  claim 25 , wherein the coronary arm comprises two coronary arms. 
     
     
         28 . The valve assembly of  claim 27 , wherein the second end of each coronary arm is configured to align with an ostium of a respective coronary artery. 
     
     
         29 . The valve assembly of  claim 28 , wherein the valve assembly is configured such that when the valve assembly is in the radially expanded deployed configuration and the coronary arms are in the longitudinally expanded deployed configuration, the central passage of the frame is in fluid communication with the longitudinal passage of each of the coronary arms, and the longitudinal passage of each of the coronary arms is in fluid communication with the respective coronary artery. 
     
     
         30 . A method of implanting a valve assembly at a location of a native valve comprising the steps of:
 advancing the valve assembly in a radially compressed delivery configuration to the location of the native valve, wherein the valve assembly includes a generally tubular frame having a first end and a second end, the frame defining a central passage and a central axis, a prosthetic valve coupled to the frame, a coronary orifice extending between an inner surface and an outer surface of the frame, and a coronary arm having a generally tubular structure, a first end of the coronary arm coupled to the coronary orifice of the frame and a second end of the coronary arm disposed adjacent to the first end with the coronary arm in a longitudinally collapsed delivery configuration;   rotationally orienting the valve assembly such that the coronary arm is aligned with an ostium of a coronary artery;   deploying the valve assembly such that the frame expands from the radially compressed delivery configuration to a radially expanded deployed configuration with the frame engaging an inner surface of the native valve and the aortic sinuses;   deploying the coronary arm from the longitudinally compressed delivery configuration to a longitudinally extended deployed configuration such that the second end of the coronary arm is extended away from the first end and the second end is disposed within the coronary artery.   
     
     
         31 . The method of  claim 30 , wherein the valve assembly includes two coronary arms, and wherein the step of rotationally orienting the valve assembly comprises aligning one of the two coronary arms with the left coronary artery and the other of the two coronary arms with the right coronary artery.