Prosthetic mitral valve with improved anchors and seal

Abstract

Disclosed herein are embodiments of an expandable replacement heart valve prosthesis. The expandable replacement heart valve prosthesis can include a number of different features, such as an hourglass (or generally hourglass) shape in the fully expanded position, anchor stiffening features, and improved retraction/retention configurations. For example, certain struts on the prosthesis can have different thicknesses/widths than other struts to improve compressibility.

What is claimed is: 
     
         1 . A heart valve prosthesis configured to transition between a compressed configuration and an expanded configuration, the prosthesis comprising:
 an inner frame having a curved hourglass shape when the prosthesis is in the expanded configuration;   an outer frame connected to the inner frame,   wherein, when the prosthesis is in the expanded configuration, a longitudinal length of the outer frame overlaps with at least an intermediate region of the inner frame;   a valve body coupled to a curved interior surface of the inner frame, wherein the curved interior surface is formed by the curved hourglass shape of the inner frame, the valve body comprising a plurality of leaflets arranged to allow blood flow in a first direction and prevent blood flow in a second direction, wherein each of the leaflets has a longitudinal curvature when the valve body is in an open configuration; and   a fabric skirt connected to an inner surface of the outer frame and extending distally beyond a distal end of the outer frame,   wherein, when the prosthesis is in the expanded configuration and the valve body is in the open configuration, the longitudinal curvatures of the leaflets follow the curved hourglass shape of the inner frame such that the leaflets conform to and lie flush against the curved interior surface of the inner frame.   
     
     
         2 . The heart valve prosthesis of  claim 1 , wherein a free edge of each leaflet is spaced away from the inner frame. 
     
     
         3 . The heart valve prosthesis of  claim 1 , wherein over 90% of a longitudinal length of each of the leaflets contacts the curved interior surface of the inner frame when the valve body is in the open configuration. 
     
     
         4 . The heart valve prosthesis of  claim 2 , wherein only the free edge of each leaflet does not contact the inner frame when the valve body is in the open configuration. 
     
     
         5 . The heart valve prosthesis of  claim 1 , wherein an upper region of the inner frame and an upper region of the outer frame each comprises corresponding eyelets, and wherein the inner frame and the outer frame are attached via the corresponding eyelets of the inner frame and the outer frame. 
     
     
         6 . The heart valve prosthesis of  claim 1 , wherein, when the prosthesis is in the expanded configuration and when the valve body is in the open configuration, an intermediate portion of a longitudinal length of each leaflet contacts a waist of the intermediate region of the inner frame. 
     
     
         7 . The heart valve prosthesis of  claim 1 , wherein the inner frame further comprises a plurality of inner frame anchoring features extending radially outwardly and then proximally toward a proximal end of the prosthesis when the prosthesis is in the expanded configuration. 
     
     
         8 . The heart valve prosthesis of  claim 7 , wherein the plurality of inner frame anchoring features comprises nine inner frame anchoring features. 
     
     
         9 . The heart valve prosthesis of  claim 1 , wherein the outer frame has a bulbous shape, wherein an intermediate region of the outer frame has a larger diameter as compared to a proximal end and the distal end of the outer frame. 
     
     
         10 . The heart valve prosthesis of  claim 1 , wherein the outer frame comprises a circumferential shoulder spaced from a proximal end of the outer frame and the distal end of the outer frame, the circumferential shoulder being a radially outermost portion of the outer frame. 
     
     
         11 . The heart valve prosthesis of  claim 1 , wherein the fabric skirt is connected to an outer surface of a distal end of the inner frame, and wherein the fabric skirt is held in tension between the outer frame and the inner frame. 
     
     
         12 . A heart valve prosthesis configured to transition between a compressed configuration and an expanded configuration, the prosthesis comprising:
 an inner frame comprising an upper region, an intermediate region, and a lower region,   wherein the intermediate region has a narrower diameter than both the upper region and the lower region when the prosthesis is in the expanded configuration so as to form an interior surface that tapers radially inward from the upper region toward the intermediate region and tapers radially outward from the intermediate region to the lower region;   an outer frame connected to the inner frame,   wherein, when the prosthesis is in the expanded configuration, at least the intermediate region of the inner frame is positioned radially within a portion of a length of the outer frame; and   a valve body connected along the interior surface of the inner frame, the valve body comprising a plurality of leaflets arranged to allow blood flow in a first direction and prevent blood flow in a second direction,   wherein, when the valve body is in an open configuration, each of the leaflets has a longitudinal curvature that conforms to the interior surface of the inner frame.   
     
     
         13 . The heart valve prosthesis of  claim 12 , wherein the upper region of the inner frame and an upper region of the outer frame each comprises corresponding eyelets, and wherein the inner frame and the outer frame are attached together via the corresponding eyelets of the inner frame and the outer frame. 
     
     
         14 . The heart valve prosthesis of  claim 12 , wherein, when the prosthesis is in the expanded configuration and when the valve body is in the open configuration, an intermediate portion of a longitudinal length of each of the leaflets contacts a waist of the intermediate region of the inner frame. 
     
     
         15 . The heart valve prosthesis of  claim 12 , wherein the inner frame further comprises a plurality of inner frame anchoring features extending radially outwardly and then proximally toward a proximal end of the prosthesis when the prosthesis is in the expanded configuration. 
     
     
         16 . The heart valve prosthesis of  claim 12 , wherein the outer frame comprises a circumferential shoulder spaced from a proximal end of the outer frame and a distal end of the outer frame, the circumferential shoulder being a radially outermost portion of the outer frame. 
     
     
         17 . A heart valve prosthesis configured to transition between a compressed configuration and an expanded configuration, the prosthesis comprising:
 an inner frame comprising an upper region, an intermediate region, and a lower region,   wherein the intermediate region has a smaller diameter than the upper region and the lower region so as to form a first curved interior surface extending from the upper region to the intermediate region and a second curved interior surface extending from the lower region to the intermediate region;   an outer frame connected to the inner frame, and   a valve body positioned within the inner frame, the valve body comprising a plurality of leaflets arranged to allow blood flow in a first direction and prevent blood flow in a second direction,   wherein, when the valve body is in an open configuration, a longitudinal length of each leaflet is adapted to have a final curvature that conforms to and contacts the first and second curved interior surfaces of the inner frame.   
     
     
         18 . The heart valve prosthesis of  claim 17 , wherein over 90% of the longitudinal length of each leaflet contacts at least one of the first and second curved interior surfaces of the inner frame when the valve body is in the open configuration. 
     
     
         19 . The heart valve prosthesis of  claim 17 , wherein only free edges at distal ends of the leaflets do not contact the inner frame when the valve body is in the open configuration. 
     
     
         20 . The heart valve prosthesis of  claim 17 , wherein the upper region of the inner frame and an upper region of the outer frame each comprises corresponding eyelets and wherein the inner frame and the outer frame are attached together via the corresponding eyelets of the inner frame and the outer frame.