Replacement heart valve with fewer sutures

Abstract

To provide a heart valve replacement device capable of reducing the number of sutures considerably.SOLUTION: A heart valve replacement device 100 comprises a stent 102 having a first end 104, a second end 106, an outer surface 110, and an inner surface 112, the inner surface defining a lumen 114; and a valve 108 disposed within the lumen of the stent, the valve formed from a single sheet of tissue, the valve having an outer surface, an inner surface, and a thickness between the outer surface and the inner surface, the valve comprising at least three leaflets, wherein, the valve is attached to the stent with minimal sutures. The leaflets are formed with a curvilinear surface.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to novel and advantageous heart valves formed from biomaterials. [Background technology]

[0002] The Background of the Invention section of this specification is intended to provide a general disclosure, and other inventions by the inventors of this application should not be admitted as prior art to the extent that they are described in this Background section, as well as aspects that are not considered prior art at the time of filing the application.

[0003] When a patient has a disease such as congenital heart defect or valvular heart disease, it is necessary to replace the native valve. A diseased heart valve can lead to regurgitation, where the valve does not function properly and blood flows in the opposite direction to the normal flow, or stenosis, where the valve is blocked due to calcification, plaque, inflammation, etc. Heart valves are replaced by surgical repair or to the native valve using a transcatheter approach. Transcatheter valve replacement devices include tissue valve leaflets attached to an expandable or self-expanding stent structure that is crimped onto a catheter for deployment. The stent is advanced to the location of the problematic heart valve where it expands or is expanded by a balloon or other means. Once installed in the valve, the tissue valve leaflets open and close due to blood flow and the heart muscle. One of the most time-consuming and labor-intensive steps in manufacturing these transcatheter valve replacement devices is the secure attachment of the valve leaflets to the stent. The valve leaflets are attached to the stent with hundreds of sutures, typically sewn by hand by skilled workers. In many cases, each valve replacement device has 150-300 or more sutures. To reduce the cost and time required to manufacture such devices, it would be desirable to significantly reduce the number of sutures required to securely attach tissue to an expandable or self-expanding stent. Summary of the Invention

[0004] The following presents a simplified summary of one or more embodiments of the invention in order to provide a basic understanding of such embodiments. This summary is not an extensive overview of all possible embodiments, nor is it intended to identify all key or critical elements or to delineate the scope of any or all embodiments.

[0005] In some embodiments, a heart valve replacement device according to the present invention comprises a stent having a first end, a second end, an outer surface, and an inner surface forming a lumen; and a valve disposed within the lumen of the stent, the valve being formed from a single sheet of tissue, the valve having an outer surface, an inner surface, and a constant thickness between the outer surface and the inner surface, the valve comprising at least three valve leaflets, and attached to the stent with fewer than 40 sutures. In some embodiments, the valve is attached to the stent with fewer than 30 sutures. In some embodiments, the valve is attached to the stent with fewer than 20 sutures. In some embodiments, the valve is attached to the stent with between 3 and 20 sutures. In some embodiments of the present invention, the valve has a body portion connected to the valve leaflets. In at least one embodiment, the thickness of the body portion is different from the thickness of the valve leaflets. In some embodiments, the valve has a fold portion, the fold portion being coupled to the body portion of the valve. In at least one embodiment, the thickness of the fold portion is different from the thickness of the body portion. In at least one embodiment, the thickness of the fold portion is different from the thickness of the valve leaflets. In at least one embodiment, the turn portion can expand from a first position to a second position relative to the stent. The stent of the heart valve replacement device can have at least one attachment element. In some embodiments, at least one suture connects the stent to the valve at a particular attachment element.

[0006] In some embodiments of the invention, the replacement heart valve comprises a plurality of valve leaflets and a body portion connected to the valve leaflets, the body portion and the valve leaflets being formed from a single sheet of tissue material. The replacement heart valve comprises a cuff portion connected to the body portion. In some embodiments, the thickness of the valve leaflets is different from the thickness of the cuff portion. In some embodiments, the thickness of the body portion is different from the thickness of the cuff portion. In the heart valve of claim 14, the tissue material is an artificial tissue. In some embodiments, the tissue material is a biomaterial. In some embodiments, the valve comprises an attachment site on at least the body portion of the heart valve.

[0007] In some embodiments, a method of manufacturing a heart valve replacement device includes forming a valve from a single sheet of tissue material, the valve having a body with at least three valve leaflets connected to the body, inserting the valve formed from the single sheet of material into a lumen of a stent, and securing the valve to the stent with fewer than 40 sutures. In some embodiments, the valve is secured to the stent with fewer than 30 sutures. In some embodiments, the valve is secured to the stent with fewer than 20 sutures. In some embodiments, the valve is secured to the stent with between 3 and 20 sutures. In some embodiments, forming the valve includes inserting the single sheet of tissue material into a mold. The mold has a lower portion (first mold) and an upper portion (second mold). In some embodiments, the mold has a locking member for locking the upper portion to the lower portion. In some embodiments, a spacer is inserted between the single sheet of tissue material and at least one of the upper portion and the lower portion. In some embodiments, a cross-linking step is performed on the single sheet of tissue material in the mold. The tissue material, in some embodiments, can be an artificial tissue or a biomaterial. In some embodiments, the single sheet of tissue material has a non-uniform thickness from one end of the material to the other. In some embodiments, the single sheet of material is cut from one end of the material to the other with a cutting device, so that the single sheet of material has a non-uniform thickness from one end of the material to the other.

[0008] While multiple embodiments are disclosed, other embodiments of the present application will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be understood, the various embodiments of the invention can be modified in various obvious aspects without departing from the spirit and scope of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative and not restrictive.

[0009] While the specification concludes with claims which particularly point out and distinctly claim the subject matter which is regarded as forming various embodiments of the invention, it is believed the present invention can be better understood by reference to the following detailed description taken in conjunction with the accompanying drawings in which: [Brief description of the drawings]

[0010] [Figure 1] FIG. 1 is a perspective view of a heart valve replacement device including a heart valve positioned relative to a stent structure according to an embodiment of the present disclosure. [Diagram 2] FIG. 2 is a first side view of the heart valve replacement device of FIG. 1 . [Diagram 3] FIG. 2 is a second side view of the heart valve replacement device of FIG. 1 . [Figure 4] FIG. 2 is a view of the distal end of the heart valve replacement device of FIG. 1 . [Diagram 5] FIG. 2 is a view of the proximal end of the heart valve replacement device of FIG. 1. [Figure 6] 1 is a perspective view of a heart valve replacement device comprising a heart valve positioned relative to a stent structure according to an embodiment of the present invention; [Figure 7] 1 is a perspective view of a heart valve according to an embodiment of the present invention; [Figure 8] FIG. 8 is a side view of the heart valve of FIG. [Figure 9] FIG. 8 is a view from the distal end of the heart valve of FIG. [Figure 10] FIG. 8 is a view from the proximal end of the heart valve of FIG. [Figure 11] FIG. 2 is a perspective view of a mold assembly for manufacturing a heart valve of the present invention having a first mold piece and a second mold piece according to one embodiment of the present invention. [Figure 12] FIG. 12 is a top view of the first mold section of the mold assembly of FIG. [Figure 13] FIG. 12 is a bottom view of the second mold section of the mold assembly of FIG. [Figure 14] FIG. 12 is a top view of the second mold part of FIG. [Figure 15] FIG. 2 is a schematic diagram illustrating a cutting assembly for producing a heart valve from biomaterial in accordance with one embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] The present invention relates to a replacement heart valve for use with the mitral, tricuspid, aortic, or pulmonary valve of the heart. In some circumstances, the replacement heart valve is placed inside the native valve such that a portion of the replacement heart valve, or a portion of a device, such as a stent, attached to the replacement heart valve is adjacent to the native heart valve.

[0012] In the following detailed description, numerous specific details are set forth to provide a thorough understanding of some embodiments. However, it will be understood by those skilled in the art that some embodiments may be practiced without these specific details. In other instances, well-known methods, procedures, components, units and / or circuits have not been described in detail to avoid obscuring discussion.

[0013] 1-5 show a heart valve replacement device 100 comprising a stent 102 having a proximal end 104 and a distal end 106, and a valve 108 disposed within the lumen of the stent and coupled to the stent 102 at a location distal to the proximal end 104. This specification uses the terms "proximal" and "distal" in the same relative manner with respect to the device shown in the figures, however, it is within the scope of the invention that "proximal" and "distal" are interchangeable with "distal" and "proximal" in alternative embodiments. The stent 102 can have any configuration and is expandable from a first position to an expanded position. As shown in FIGS. 1-5, the stent 102 is in an expanded position. The stent 102 can be self-expandable, balloon expandable, or otherwise expandable from a first position to a second position. The stent 102 has an exterior surface 110 and an interior surface 112, the interior surface 112 forming a lumen 114 over at least a portion of the stent. In at least one embodiment, the exterior surface 110 has a layer of coating material. In at least one embodiment, the interior surface 112 may have a layer of coating material to reduce friction with the valve 108. The stent 102 has one or more attachment elements 115 on the exterior surface 110, the interior surface 112, or both, for connecting the valve 108 to the stent 102. In at least one embodiment, at least one attachment element 115 may have a radiopaque marker or coating for imaging to aid in positioning the heart valve replacement device 100 within the vascular system.

[0014] The valve 108 is attached to the stent by one or more attachment elements 115 using sutures or another mechanical means. The valve 108 may be attached to the stent 102 with an adhesive. The valve 108 may be attached to the stent 102 by attachment elements using an adhesive. The valve 108 may also be attached to the stent 102 using a polymeric attachment layer. In some embodiments, the valve 108 may be attached using one or more of sutures, another mechanical attachment means, an adhesive, or a polymeric attachment layer.

[0015] The valve 108, in some embodiments, is formed from a single piece of tissue material. In some embodiments, the tissue material may be a biomaterial. In some embodiments, the tissue material may comprise acellular or cellular tissue selected from the group consisting of cardiovascular tissue, heart tissue, heart valve, aortic root, aortic wall, aortic valve leaflets, pericardial tissue, connective tissue, dura mater, dermal tissue, vascular tissue, cartilage, pericardium, ligament, tendon, blood vessel, umbilical cord tissue, bone tissue, fascia, and submucosa, and skin. In some embodiments, the tissue material is an implantable biomaterial, such as those described in U.S. Pat. No. 9,205,172, entitled "Implantable Biomaterial and Method for Manufacturing Same," filed Dec. 21, 2005, which is incorporated herein by reference in its entirety. In some embodiments, the biomaterial may be an artificial tissue. In some embodiments, the artificial tissue may be comprised of a single piece of molded or formed polymer. In some embodiments, the artificial tissue may be comprised of polytetrafluoroethylene, polyethylene terephthalate, another polymer, and another polymer coating.

[0016] The valve 108 has a proximal end 116 and a distal end 118. The valve 108 has an exterior surface 122 and an interior surface 124, the interior surface 124 defining a lumen 125. The valve 108 has at least one valve leaflet 126. In some embodiments, the valve 108 comprises at least three valve leaflets 126 connected to one another. In some embodiments, the valve 108 comprises three valve leaflets 126. In some embodiments, the valve 108 comprises two valve leaflets 126. In some embodiments, the valve 108 comprises four valve leaflets 126. In some embodiments, the valve 108 comprises more than four valve leaflets 126. Each of the valve leaflets 126 forms a cup-shaped recess 128. Thus, the valve leaflets 126 are formed in a curved shape rather than a flat piece of tissue. Studies such as those published in the article entitled "Flat or Curved Pericardial Aortic Valve Leaflets: A Finite Element Study" by Khee Hiang Lim, Johanes Candral, Joon Hock Yeo, Carlos MG Duran et al. in Journal of Heart Valve, Vol. 13, No. 5 (September 2004), which is incorporated herein by reference in its entirety, show that three-dimensional valve leaflet cusps similar to those shown herein reduce stress by about 35% relative to flat tissue pieces. The valve leaflets 126 are disposed adjacent to one another at commissures 130. The valve 108 further comprises a body portion 132 connected to at least the valve leaflets 126. In some embodiments, the body portion 132 is disposed distally relative to the valve leaflets. In at least one embodiment, the valve 108 has an annular portion 138 at the distal end 112. The annular portion 136 is coupled to the body portion 132. In some embodiments, the valve 108 has a cuff 140 attached to the annular portion 138. The cuff 140 has an outer surface 142 and an inner surface 144. The cuff 140 extends proximally over at least a portion of the body portion 132. The cuff 140, in some embodiments, may expand to form a seal with biological tissue. In some embodiments, the valve 108 further comprises a first end 146 and a second end 147 that form a seam 148 that extends axially along the valve 108. In some embodiments, the seam 148 is joined using some adhesive or another chemical process.In some embodiments, the first end 146 and the second end 147 are joined across the seam 148 by a single suture. In some embodiments, the first end 146 and the second end 147 are joined across the seam 148 by a first suture near the proximal end of the seam 148 and a second suture near the distal end of the seam 148. In some embodiments, the first end 146 and the second end 147 are joined across the seam 148 by a first suture near the proximal end of the seam 148, a second suture near the distal end of the seam 148, and at least one suture between the first and second sutures. In other embodiments, the seam 148 may form a relatively small gap between the first and second ends 146 and 147 without compromising the performance of the valve. In some embodiments, the valve leaflets 126 have a constant thickness between the outer surface 122 and the inner surface 124 that is less than the thickness of the body portion.

[0017] The valve 108 is positioned relative to the stent 102 such that the outer surface 122 of at least a portion of the valve 108 abuts the inner surface 112 of the stent 102. As shown in at least FIG. 3, the valve 108 is attached to the stent 102 using sutures 150. The sutures 150 are used to connect the turnup portion 140 to one of the body portion 132 or the stent 102. The sutures 150 are used to connect the body portion 133 to the stent 102. The sutures 150 are used to connect the commissures 130 to the stent 102. In at least one embodiment, the sutures 150 are used to connect the commissures 130 to the stent 102 at the attachment sites 115. In some embodiments, at least the outer surface 122 of the body portion 132 abuts the inner surface 112 of the stent 102. In some embodiments, the inner surface 144 of the fold 140 abuts the outer surface 110 of the stent 102 at a first location. In some embodiments, the inner surface 144 of the fold 140 abuts the outer surface 110 of the stent 102 in a second, expanded configuration as shown in Figures 1-5. In some embodiments, when placed at the native valve, blood flow through the valve and blood pressure in the blood vessel may cause the fold 140 to expand or move away from the outer surface 110 of the stent 102 to form a seal against the native valve.

[0018] At least in part because the valve is formed from a single piece of material, the valve may be attached to the stent with a minimum of sutures. In some embodiments, FIG. 6 illustrates an embodiment of a heart valve replacement device 600 with a valve 608 attached to the stent 602 with only fifteen sutures 650. The valve 608 is attached to the stent 602 with at least attachment elements 615. In some embodiments, the attachment elements 615 are adapted to align with the commissures 630 between the valve leaflets 626 of the valve 608. The valve 608 is attached at the attachment elements 615 with a first set of sutures 650a. In at least one embodiment, the first set of sutures 650a includes three sutures 650. The valve 608 is further attached with a second set of sutures 650b at or near the end of the stent. In some embodiments, the sutures of the second set of sutures 650b join the turn portion 640 of the valve 608 to the stent 602. In some embodiments, the second set of sutures 650b join the turn portion 640 to the body portion 632 overlapping the turn portion 640. In at least one embodiment, the second set of sutures 650b is a continuous set of sutures that traverse the circumference of the valve 608 at the outer surface 622 of the valve near the distal end of the stent. In at least one embodiment, the second set of sutures 650b is a continuous set of sutures that traverse the circumference of the valve at the edge 655 of the distal end 606 of the stent 602. In at least one embodiment, the second set of sutures 650b includes nine sutures 650. In at least one embodiment, the valve 608 is attached with a third set of sutures 650c. The third set of sutures 650c are axially disposed between the first set of sutures 650a and the second set of sutures 650b. The third set of sutures 650c may couple the body portion 632 to the stent 602. The third set of sutures 650c may include three sutures 650. The third set of sutures 650c, in some embodiments, are each axially aligned with the first set of sutures 650a. The third set of sutures 650c, in some embodiments, are radially offset and disposed distally from the sutures of the first set of sutures 650a.In at least one embodiment, at least one suture of the third set of sutures 650c may connect tissue across joint 648 of valve 602. Alternative suture configurations are contemplated by the present invention.

[0019] 7-10 show an embodiment of a valve 700. The valve 700 is not formed as a flat sheet of tissue before being inserted into a stent structure, but rather is formed as a cylindrical structure before being inserted into a stent structure or another structure for placement in a native valve. In some embodiments, the tissue material is an artificial tissue. In some embodiments, the tissue material is a biomaterial. In some embodiments, the tissue material can be a cross-linked collagen-based biomaterial comprising acellular or cellular tissue selected from the group consisting of cardiovascular tissue, heart tissue, heart valves, aortic root, aortic wall, aortic valve leaflets, pericardial tissue, connective tissue, dura mater, dermal tissue, vascular tissue, cartilage, pericardium, ligament, tendon, blood vessel, umbilical cord tissue, bone tissue, fascia, and submucosa, and skin. In at least some embodiments, the tissue material is an implantable biomaterial, such as those described in U.S. Pat. No. 9,205,172, filed Dec. 21, 2005, entitled "Implantable Biomaterial and Method for Manufacturing Thereof," which is incorporated herein by reference in its entirety. The valve 700 comprises a proximal end 702 and a distal end 704. The valve 700 has an exterior surface 706 and an interior surface 710, the interior surface 710 forming a lumen 712. In some embodiments, the valve 700 comprises a body portion 714 and at least three valve leaflets 716 connected to the body portion 714. In some embodiments, the valve 700 comprises three valve leaflets 716. In some embodiments, the valve 700 comprises four valve leaflets 716. In some embodiments, the valve 700 comprises more than four valve leaflets 716 or more. The valve leaflets 716 have a curved portion 718. The curved portion 718 forms a cup-shaped recess. The valve leaflets 716 are disposed adjacent to one another at a commissure 720. In at least one embodiment, the valve 108, the body portion 714 has an annular portion 722 at the distal end 704. In some embodiments, the valve 700 has a cuff portion 724 attached to the annular portion 722. The cuff portion 724 has an outer surface 726 and an inner surface 728. The cuff portion 724 extends proximally over at least a portion of the body portion 714. The cuff portion 724, in some embodiments, can expand to form a seal against native tissue.

[0020] In some embodiments, a method of making a valve of the invention may include inserting a sheet of tissue into a mold to form the valve leaflets and folds, and in some configurations forming the shaped tissue into a circular ring. FIGS. 11-14 show an embodiment of a mold 1100. The mold comprises an upper portion 1120 and a lower portion 1122. The upper portion 1120 and the lower portion 1122 may be separate components or may be connected to one another. In at least one embodiment, the upper portion 1120 and the lower portion 1122 are formed as a bivalve shell-like structure, with the upper portion 1120 and the lower portion 1122 pivotally connected to one another at at least one hinge location. FIG. 11 shows the mold in a closed position. In at least one embodiment, the upper portion 1120 and the lower portion 1122 are fixedly connected to one another in the closed position using a locking means 1123. In one embodiment, the locking means 1123 comprises a first hole 1124 and a second hole 1126 in the upper portion 1120 and a first hole 1128 and a second hole 1130 in the lower portion 1122 that are alignable with the first hole 1124 and the second hole 1126. Bolts can be inserted into the first holes 1124, 1128 and the second holes 1128, 1130 and tightened with nuts. The locking means 1123 also comprises a clamp that presses against the upper portion 1120 and the lower portion 1122. Other means for locking the upper portion 1120 in a closed position relative to the lower portion 1122 are also contemplated by the present invention. When the locking means 1123 is engaged, a desired force can be applied to tissue disposed within the mold.

[0021] The lower portion 1122 of the mold 1100 is shown in FIG. The lower portion 1122 includes at least one valve leaflet 1134, a commissure 1136 between adjacent valve leaflets 1134, and a body portion 1138 connected between the commissure 1136 and the valve leaflet 1134. As shown in FIG. 12, the lower portion 1122 has three valve leaflets 1134. In some embodiments, the lower portion 1122 has two valve leaflets 1134. In some embodiments, the lower portion 1122 has four valve leaflets 1174. In some embodiments, the lower portion 1122 has four or more valve leaflets 1134. In at least one embodiment, the valve leaflet 1134 can include a male forming element. The valve leaflet 1134 includes at least one convex forming portion 1135 and a depressed portion 1137. At least one convex feature 1135 has a curved outer surface 1140, a first curved end 1142 at a first end 1144, and a second curved end 1146 extending from the first end 1144 to a second end 1148 tangent to the adjacent commissure 1136. The first curved end 1142 forms a parabola. The first curved end 1142 and the second curved end 1146 intersect at a location 1150. As shown in FIG. 12, the valve leaflet 1134 has two convex features 1135. The first curved end 1142 of the first convex feature intersects with the first curved end 1142 of the second convex feature at a location 1152. The location 1152 is disposed above the recess 1137. Each of the first curved ends 1142 forms a parabola. The second curved end 1146 of the first convex formation 1135 intersects with the second curved end 1146 of the second convex formation 1135 at location 1144. The second curved end 1146 of the first convex formation 1135 and the second curved end 1146 of the second convex formation 1135 form a parabola. In some embodiments, the shape of the valve leaflet 1134 is similar to the valve leaflet mold described in U.S. Patent No. 6,491,511, entitled "Mold for Forming a Stentless Replacement Heart Valve from a Biological Membrane," filed on October 14, 1999, the contents of which are incorporated herein by reference. A body portion 1138 is connected to the commissure portion 1136. The body portion 1138 is generally flat and extends outwardly from the lower portion 1122.In some embodiments, the lower portion 1122 includes locking flanges 1160, 1162 extending outwardly on either side of the valve leaflet 1134, with the locking flanges 1160, 1162 including first and second holes 1128, 1130, respectively.

[0022] The upper portion 1120 of the mold 1100 is shown in FIGS. 13-14. The upper portion 1120 includes at least one valve leaflet 1174 and a commissure 1176 between adjacent valve leaflets 1174. As shown in FIG. 13, the upper portion 1120 includes three valve leaflets 1174. In some embodiments, the upper portion 1120 includes two valve leaflets 1174. In some embodiments, the upper portion 1120 includes four valve leaflets 1174. In some embodiments, the upper portion 1120 includes more than four valve leaflets 1174. In at least one embodiment, the valve leaflet 1174 includes a female forming element that engages a corresponding male forming element of the valve leaflet 1134 of the lower portion 1122. The valve leaflet 1174 includes at least one recessed forming portion 1178 and a second portion 1179. When in the closed position, at least one concave feature 1178 of the top portion 1120 engages with at least one convex feature of the bottom portion 1122. The at least one concave feature 1178 has a curved surface 1180, a first curved end 1182 at a first end 1184, and a second curved end 1186 that is tangent to the adjacent commissure 1178 and extends from the first end 1184 to a second end 1188. In some embodiments, when the mold is in the closed position, the second end 1148 of the bottom portion 1148 aligns with the second end 1188 of the top portion. The first curved end 1182 forms a parabola. The first curved end 1182 and the second curved end 1186 intersect at location 1190. The first curved end 1182 of the first recessed formation intersects with the first curved end 1182 of the second recessed formation at location 1192. Location 1192 is disposed adjacent to the second portion 1179. The first curved ends 1182 each form a parabola. The second curved end 1186 of the first recessed formation intersects with the second curved end 1186 of the second recessed formation at location 1194. The second curved end 1186 of the first recessed formation and the second curved end 1186 of the second recessed formation form a parabola. In some embodiments, the shape of the valve leaflets 1174 is similar to the valve leaflet mold described in U.S. Pat. No. 6,491,511, filed Oct. 14, 1999, and entitled "Mold for Forming a Stentless Replacement Heart Valve from a Biological Membrane," the contents of which are incorporated herein by reference. In some alternative embodiments, the body portion is connected to the commissures 1176 and the valve leaflets 1174 .The body portion is connected to the commissures 1176. The body portion 1138 is generally planar and extends outwardly from the commissures 1176. The body portion overlaps at least a portion of the body portion of the lower portion 1122 when in the closed position. The body portion of the upper portion 1120 is shorter than the body portion of the lower portion. The ends of the body portion of the upper portion 1120 define the ends of the annulus of the formed valve. In some embodiments, the upper portion 1120 has locking flanges 1196, 1198 extending outwardly on either side of the valve leaflets 1174, the locking flanges 1196, 1198 having first and second holes 1124, 1126, respectively. The upper portion 1120 has a plurality of channels 1199 near the second end 1188.

[0023] In some embodiments, the mold is formed from a metal, polymer, or ceramic material. In some embodiments, the mold may be printed using additive manufacturing such that the mold is individualized for a patient to form a valve specific to that patient.

[0024] In at least one embodiment, a sheet of tissue is inserted into the mold 1100 between the lower portion 1122 and the upper portion 1124. The locking member 1123 is then engaged to secure the lower portion 1122 and the upper portion 1124 in a closed position. In at least one embodiment, the sheet of tissue is formed from a biological sample and a cross-linking solution, glutaraldehyde, is used on the sheet of tissue to facilitate cross-linking of the tissue. In some embodiments, the cross-linking solution contains glutaraldehyde. In some embodiments, the cross-linking solution is injected into the tissue, and in other embodiments, the tissue is soaked, immersed, or infiltrated in the cross-linking solution. In some embodiments, glutaraldehyde is injected into the tissue, and in other embodiments, the tissue is soaked, immersed, or infiltrated with glutaraldehyde. In at least one embodiment, the mold 1100 and the sheet of tissue inserted into the mold are soaked in a cross-linking solution, the solution containing glutaraldehyde. In at least one embodiment, the top portion 1124 is removed from the mold 1100 when the tissue is partially crosslinked and the tissue is removed from the mold 1100 when the tissue is fully crosslinked. In at least one embodiment, the top portion 1124 is removed from the mold 1100 while the mold 1100 is immersed in a crosslinking solution or glutaraldehyde. In at least one embodiment, a spacer or spacing layer is inserted between at least one of the bottom portion 1122 and top portion 1124 prior to applying glutaraldehyde to the sheet of tissue.

[0025] In some embodiments, the valve is formed from a single sheet of material having a non-uniform thickness. In some embodiments, a method of manufacturing a sheet of tissue for a valve includes using a cutting system 1500 as shown in FIG. 15. The cutting system 1500 includes a first tissue holder 1502 and a second tissue holder 1504 that apply tension to a tissue sheet 1505 held between the two tissue holders 1502, 1504. In at least one embodiment, the first tissue holder 1502 and the second tissue holder 1504 are driven by servo motors to move the tissue in a first direction. In at least one embodiment, the first tissue holder 1502 and the second tissue holder 1504 are driven by servo motors. In such an embodiment, the servo motor of the first tissue holder 1502 operates in unison with the servo motor of the second tissue holder to maintain a constant predetermined tension on the tissue sheet 1505. In at least one embodiment, the second tissue holder 1504 is positioned orthogonal to the first tissue holder 1502. The rollers 1506 are positioned between the first tissue holder 1502 and the second tissue holder 1504. In some embodiments, the cutting system 1500 has rollers 1506 driven by a motor to move the tissue from the first tissue holder to the second tissue holder. The rollers 1506 are aligned with both the first tissue holder 1502 in a first direction and the second tissue holder 1504 in a second direction. In at least one embodiment, the rollers 1506 can position the tissue with respect to the cutting blade 1508. The cutting system 1500 has the blade 1508 operably connected to a motor driven shaft that can adjustably move the blade toward or away from the rollers 1506 (and tissue) depending on the desired tissue thickness. In at least one embodiment, the blade 1508 is connected to a servo motor that drives a ball screw for precise distance accuracy. An operator or computer can direct the user to move the blade towards or away from the tissue to provide tissue with a desired non-uniform thickness along the sheet.In at least one embodiment, the blade is a vibrating blade and vibrates at a high frequency, for example 3500 cycles per minute. As the tissue passes over the blade 1508, in some embodiments, the undesired tissue 1510 separates from the remaining tissue attached to the second tissue holder 1504, essentially splitting the tissue into two portions. The desired tissue attached to the tissue holders 1502, 1504 is then cut into a sheet for insertion into a mold to form the valve. In another embodiment, as the tissue passes over the blade 1508, the desired tissue 1510 used to form the valve separates from the remaining tissue attached to the second tissue holder 1504.

[0026] As used herein, the term "approximately" or "generally" refers to the complete or nearly complete extent or extent of an action, property, characteristic, state, structure, item, or result. For example, an object that is "approximately" or "generally" encompassed means that the object is either completely encompassed or nearly completely encompassed. The exact degree of deviation from absolute completeness will depend in some cases on the specific context. Generally speaking, however, approaching completeness will generally have the same overall result as if absolute and total completeness had been achieved. The use of the term "approximately" or "generally" when used in a negative sense is similarly used to refer to the complete or nearly complete lack of an action, feature, characteristic, state, structure, item, or result. For example, an element, combination, embodiment, or composition that is "approximately" devoid or "generally" devoid of a certain component or element may still actually contain such item, so long as there is generally no measurable effect of it.

[0027] References herein to "one embodiment" or "an embodiment" mean that a particular element, feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment. References herein to "one embodiment" do not necessarily all refer to the same embodiment.

[0028] As used herein, the terms "comprises," "comprising," "includes," "including," "has," "having," or other variations of these terms are intended to cover non-exclusive inclusions. For example, a process, method, article, or apparatus that comprises a list of certain elements is not necessarily limited to those elements, but may also include other elements not expressly listed or inherent to such process, method, article, or apparatus. Furthermore, unless expressly stated to the contrary, the term "or" refers to an inclusive "or," not an exclusive "or." For example, A or B is satisfied by any of the following: A is true (or exists) and B is false (or does not exist), A is false (or does not exist) and B is true (or exists), and both A and B are true (or exist).

[0029] In addition, the use of "a" and "an" are used to describe elements or components of embodiments of this specification. This is merely for convenience and to give a general sense of the description. This description should be read to include one or at least one, and also includes the plural unless it is clear that this is meant otherwise.

[0030] Moreover, the drawings depict preferred embodiments for illustrative purposes only, and those skilled in the art will appreciate from the description herein that alternative embodiments of the structures and methods shown herein may be used without departing from the principles described herein.

[0031] After reading this disclosure, one skilled in the art will appreciate further alternative structural and functional designs for the devices described herein. Thus, while specific embodiments and uses have been shown and described, it should be understood that the disclosed embodiments are not limited to the precise structures and components disclosed herein. As will be apparent to those skilled in the art, various modifications, changes, and variations may be made in the arrangement, operation, and details of the methods and devices disclosed herein without departing from the spirit and scope as defined by the appended claims.

[0032] The systems and methods described herein with reference to several exemplary embodiments are not intended to be limiting and are not necessarily mutually exclusive, and specific elements of various embodiments may be omitted or combined for use with features of other components within the scope of the invention. Any feature of any embodiment herein may be used in any embodiment and may be used with any feature of another embodiment.

Claims

1. a stent having a first end, a second end, an exterior surface, and an interior surface defining a lumen; a single piece valve disposed within a lumen of the stent and attached to the stent, the single piece valve being molded from a single sheet of acellular, collagen-based biomaterial that is crosslinked during molding, the single piece valve defining a lumen and having a valve proximal end and a valve distal end; the one-piece molded valve being molded to have a molded three-dimensional shape including at least three molded valve leaflets and cross-linked during molding, each molded valve leaflet including a portion molded to have a curved three-dimensional shape with a concave profile and cross-linked during molding.

2. The heart valve replacement device of claim 1, wherein the integrally molded valve includes a main body portion formed from the biomaterial, and the main body portion of the integrally molded valve forms a folded portion at the distal end of the valve.

3. 3. The heart valve replacement device of claim 2, wherein the turn portion is expandable from a first position to a second position relative to the stent.

4. The heart valve replacement device of claim 1 , wherein the stent has at least one attachment element.

5. The heart valve replacement device of claim 4 , wherein at least one suture connects the stent to the integral valve at one attachment element.

6. a stent having a first end, a second end, an exterior surface, and an interior surface defining a lumen; a one-piece valve disposed within and attached to a lumen of the stent, the one-piece valve being molded from a single sheet of acellular, collagen-based biomaterial that is crosslinked during molding, the one-piece valve defining a lumen, and having a valve proximal end, a valve distal end, a first edge extending from the valve proximal end to the valve distal end, and a second edge opposite the first edge extending from the valve proximal end to the valve distal end; the one-piece molded valve being molded and cross-linked during molding to have a molded three-dimensional shape including at least three molded valve leaflets, each molded valve leaflet having a curved three-dimensional shape with a concave profile.

7. The heart valve replacement device of claim 6 , wherein the first edge and the second edge form a seam that extends axially from the valve proximal end to the valve distal end.

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