Frame Features For Prosthetic Mitral Valves

Abstract

Prosthetic heart valves are described herein that can provide clearance to the left ventricle outflow tract (LVOT), reduce the possibility of undesirable outflow gradients, and/or limit or prevent LVOT obstructions when implanted in the heart. In some embodiments, a prosthetic heart valve can include an outer frame having a cuff portion that is disposed at an angle (e.g., 80 degrees) relative to the vertical axis of a body portion of the outer frame, so that the prosthetic valve can seat securely in the annulus while not obstructing the ventricular outflow tract of the heart. In some embodiments, a prosthetic heart valve can alternatively, or additionally, include subvalvular components having a short profile, such that the prosthetic valve can seat securely in the annulus while not obstructing the ventricular outflow tract of the heart.

What is claimed is: 
     
         1 . A prosthetic heart valve for replacing a native heart valve, comprising:
 an outer frame assembly including an outer frame having a cuff portion at an atrial end of the outer frame configured to be disposed at least partially within an atrium of a heart and a body portion configured to be disposed in a ventricle of the heart,   the body portion having a posterior side and an opposite anterior side, the anterior side having a maximum height larger than a maximum height of the posterior side such that when the prosthetic heart valve is in a deployed configuration, an anterior side of the cuff portion of the outer frame is disposed at an acute angle relative to a centerline of the body portion of the outer frame; and   an inner valve assembly disposed within and coupled to the outer frame assembly, the inner valve assembly including an inner frame having an atrium end and a ventricle end and having a centerline substantially parallel to the centerline of the body portion of the outer frame when the prosthetic heart valve is in the deployed configuration, the inner valve assembly including a valve leaflet assembly supported on the inner frame.   
     
     
         2 . The prosthetic heart valve of  claim 1 , wherein:
 the inner frame has a maximum height defined between the atrium end of the inner frame and a location at which the inner frame is coupled to the outer frame that is greater than a maximum height of the body portion of the outer frame.   
     
     
         3 . The prosthetic heart valve of  claim 1 , wherein:
 the inner frame has a maximum height defined between the atrium end of the inner frame and a location at which the inner frame is coupled to the outer frame that is less than a maximum height of the outer frame.   
     
     
         4 . The prosthetic valve of  claim 1 , wherein:
 the inner frame has a maximum height defined between the atrium end of the inner frame and a location at which the inner frame is coupled to the outer frame that is greater than a minimum height of the outer frame.   
     
     
         5 . The prosthetic heart valve of  claim 1 , wherein the acute angle is greater than 70 degrees and less than 90 degrees. 
     
     
         6 . The prosthetic heart valve of  claim 5 , wherein the acute angle is about 80 degrees. 
     
     
         7 . The prosthetic valve of  claim 1 , wherein the inner frame is tubular and defines an inner diameter, the outer frame is tubular and defines an inner diameter at the location where the inner frame is coupled to the outer frame, the inner diameter of the inner frame being smaller than the inner diameter of the outer frame. 
     
     
         8 . The prosthetic heart valve of  claim 1 , wherein the atrium end of the inner frame is disposed below at least a portion of the atrial end of the outer frame when the prosthetic heart valve is in the deployed configuration. 
     
     
         9 . The prosthetic heart valve of  claim 1 , wherein the atrium end of the inner frame extends above at least a portion of the atrial end of the outer frame when the prosthetic heart valve is in the deployed configuration. 
     
     
         10 . A prosthetic heart valve, comprising:
 an outer frame assembly including an outer frame having a cuff portion configured to be disposed at least partially within an atrium of a heart and a body portion configured to be disposed in a ventricle of the heart; and   an inner valve assembly including an inner frame having an atrium end and a ventricle end and a valve leaflet assembly supported on the inner frame, the valve leaflet assembly including a plurality of valve leaflets, the inner frame further including a plurality of belly posts and a plurality of commissure posts, each of the plurality of valve leaflets coupled to two of the plurality of commissure posts and having a belly portion disposed adjacent to one of the plurality of belly posts, the inner valve assembly disposed within and coupled to the outer frame assembly such that a center portion of an A2 segment of the outer frame is substantially aligned with a commissure post from the plurality of commissure posts of the inner frame, wherein, in a collapsed delivery configuration, the inner frame is coupled to the outer frame.   
     
     
         11 . The prosthetic heart valve of  claim 10 , wherein the center portion of the A2 segment of the outer frame is misaligned with each belly post from the plurality of belly posts of the inner frame. 
     
     
         12 . The prosthetic heart valve of  claim 10 , wherein the commissure post is substantially aligned with the center portion of the A2 segment of the outer frame, wherein the inner frame defines a perimeter and the commissure post is spaced a radial distance from the perimeter toward a radial center of the inner frame relative to the other commissure posts of the plurality of commissure posts. 
     
     
         13 . The prosthetic heart valve of  claim 10 , wherein the plurality of belly posts define a circular perimeter and the plurality of commissure posts are each disposed within the circular perimeter such that a space is defined between each commissure post from the plurality of commissure posts and the circular perimeter. 
     
     
         14 . The prosthetic heart valve of  claim 10 , wherein a space is defined between the A2 segment of the outer frame and the commissure post from the plurality of commissure posts substantially aligned with the center portion of the A2 segment of the outer frame such that the space provides clearance to the left ventricular outflow tract of the heart when the prosthetic heart valve is disposed within the native annulus of the heart.