Low profile transcatheter heart valve

Abstract

An implantable prosthetic valve includes a radially collapsible and expandable annular frame having three commissure attachment portions and at least three rows of angled struts. The rows include a first row, a second row downstream of the first row, and a third row downstream of the second row. Each row of struts includes angled struts arranged in a zig-zag pattern defining a plurality of crowns. A leaflet structure includes three leaflets forming three commissures, each commissure being connected to one of the commissure attachment portions via sutures extending through apertures in the commissure attachment portions, wherein all of the apertures are located along the length of the frame between a first plane defined by the crowns of the second row of struts and a second plane defined by the crowns of the third row of struts.

We claim: 
     
         1 . An implantable prosthetic heart valve that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration, the prosthetic heart valve comprising:
 a radially collapsible and expandable annular frame, the frame having three commissure attachment portions and at least three rows of angled struts including a first row of angled struts defining an inflow end of the frame, a second row of angled struts downstream of the first row of angled struts, and a third row of angled struts downstream of the second row of angled struts, each row of angled struts comprising angled struts arranged in a zig-zag pattern defining a plurality of crowns, wherein the first row of struts forms exactly nine crowns at the inflow end of the frame;   a leaflet structure comprising three leaflets formed of pericardial tissue, each leaflet having an upper edge, a curved lower edge and two side flaps, wherein each side flap is secured to an adjacent side flap of another leaflet to form commissures of the leaflet structure, each commissure being sutured to one of the commissure attachment portions via sutures extending through apertures in the commissure attachment portions, wherein all of the apertures are located along the length of the frame between a first plane that is perpendicular to the length and defined by the crowns of the second row of angled struts and a second plane that is perpendicular to the length and defined by the crowns of the third row of angled struts, wherein the commissures are located entirely inside of the frame;   wherein the second and third row of struts define a row of cells defining openings in the frame, and wherein there are exactly three cells between adjacent commissure attachment portions; and   an annular skirt secured to the inside of the annular frame and to the leaflet structure, the curved lower edge of each leaflet sutured to an inner surface of the skirt.   
     
     
         2 . The prosthetic valve of  claim 1 , wherein the lower edges of the leaflets are sutured to the skirt along a scalloped shaped suture line that transects struts of the first row of struts. 
     
     
         3 . The prosthetic valve of  claim 1 , wherein the skirt has an upper edge and a lower edge, the upper edge being sutured to struts of the second row of struts, and the lower edge being sutured to struts of the first row of struts. 
     
     
         4 . The prosthetic valve of  claim 4 , wherein the upper edge of the skirt has an undulating shape forming a plurality of projections. 
     
     
         5 . The prosthetic valve of  claim 1 , wherein each side flap is folded to form an inner layer and an outer layer that extend radially inwardly from an adjacent commissure attachment portion. 
     
     
         6 . The prosthetic valve of  claim 1 , wherein each commissure attachment portion comprises a column of apertures spaced apart from each other along a length of the commissure attachment portion. 
     
     
         7 . The prosthetic valve of  claim 1 , wherein the frame is made of a plastically-expandable material. 
     
     
         8 . The prosthetic valve of  claim 1 , wherein the frame is made of Nitinol. 
     
     
         9 . The prosthetic valve of  claim 1 , wherein each commissure attachment portion is connected to adjacent ends of two struts of the second row of struts at a junction and extends from the junction toward the outflow end of the frame. 
     
     
         10 . The prosthetic valve of  claim 9 , wherein each commissure attachment portion includes apertures located downstream of the junction. 
     
     
         11 . An implantable prosthetic heart valve that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration, the prosthetic heart valve comprising:
 a radially collapsible and expandable annular frame, the frame having three commissure attachment portions and at least three rows of angled struts including a first row of angled struts defining an inflow end of the frame, a second row of angled struts downstream of the first row, and a third row of angled struts spaced downstream of the second row, each row of angled struts comprising angled struts arranged in a zig-zag pattern, wherein the second and third row of struts define a row of cells defining openings in the frame, wherein there are exactly three cells between adjacent commissure attachment portions in a circumferential direction of the row of cells; and   a leaflet structure comprising three leaflets forming three commissures of the leaflet structure, each leaflet having opposing side flaps, wherein each side flap is secured to an adjacent side flap of another leaflet to form commissures of the leaflet structure, each commissure being sutured to one of the commissure attachment portions via sutures extending through apertures in the commissure attachment portion, each commissure being connected to one of the commissure attachment portions only at locations along the commissure attachment portions located axially between an upstream end of the row of cells and a downstream end of the row of cells, wherein the commissures are located entirely inside of the frame.   
     
     
         12 . The prosthetic valve of  claim 11 , wherein the first row of struts forms exactly nine crowns at the inflow end of the frame. 
     
     
         13 . The prosthetic valve of  claim 11 , wherein each commissure attachment portion is connected to adjacent ends of two struts of the second row of struts at a junction and extends from the junction toward the outflow end of the frame. 
     
     
         14 . The prosthetic valve of  claim 11 , wherein each side flap is folded to form an inner layer and an outer layer that extend radially inwardly from an adjacent commissure attachment portion. 
     
     
         15 . The prosthetic valve of  claim 11 , further comprising an annular inner skirt secured to the inside of the annular frame and to the leaflet structure, wherein a lower edge of each leaflet sutured to the inner skirt along a suture line that transects struts of the first row of struts. 
     
     
         16 . An implantable prosthetic heart valve that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration, the prosthetic heart valve comprising:
 a radially collapsible and expandable annular frame, the frame having an inflow end, an outflow end, three commissure attachment portions and at least three rows of angled struts including a first row of angled struts defining an inflow end of the frame, a second row of angled struts downstream of the first row, and a third row of angled struts spaced downstream of the second row;   a leaflet structure comprising three leaflets, each leaflet having an upper edge, a lower edge and two side flaps, wherein each side flap is connected to an adjacent side flap of another leaflet to form commissures of the leaflet structure, each commissure being attached to one of the commissure attachment portions; and   an annular skirt positioned between the annular frame and the leaflet structure, the lower edge of each leaflet sutured to the skirt with a stitch line that forms an undulating path that extends along the lower edge of each leaflet from a first location proximate one of the commissures toward the inflow end of the frame, transects struts of the first row of struts, and then extends back toward the outflow end of the frame to a second location proximate another commissure.   
     
     
         17 . The prosthetic valve of  claim 16 , wherein the second and third row of struts define a row of cells defining openings in the frame, and wherein each commissure is sutured to one of the commissure attachment portions via sutures extending through apertures in the commissure attachment portion, each commissure being connected to one of the commissure attachment portions only at locations along the commissure attachment portions located axially between an upstream end of the row of cells and a downstream end of the row of cells. 
     
     
         18 . The prosthetic valve of  claim 17 , wherein the commissures are located entirely inside of the frame. 
     
     
         19 . The prosthetic valve of  claim 16 , wherein each side flap is folded to form an inner layer and an outer layer that extend radially inwardly from an adjacent commissure attachment portion. 
     
     
         20 . The prosthetic valve of  claim 16 , wherein each commissure attachment portion comprises a column of apertures spaced apart from each other along a length of the commissure attachment portion.