Silk-based electrospun materials for implantable systems and devices

Abstract

The implantable prosthetic valve can include an annular frame having an inner surface and an outer surface, the frame having an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end. A leaflet structure can be positioned within the frame. An inner skirt can be positioned along the inner surface of the frame. An outer skirt can be positioned around the outer surface of the frame. Various portions of the leaflet structure, inner skirt, and outer skirt can incorporate materials including electrospun silk.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Patent Application No. 63 / 016,835, filed April 28, 2020, the contents of which are incorporated by reference herein in their entirety.

[0002] The present disclosure relates to aspects of medical implant devices incorporating a material including a plurality of fibers comprising electrospun silk. The present disclosure also relates to aspects of methods of forming such medical implant devices. [Background technology]

[0003] The heart can suffer from various valvular diseases or malformations that can lead to severe cardiac dysfunction and ultimately require replacement of the native heart valve with a prosthetic valve. Human heart valves, including the aortic, arterial, mitral, and tricuspid valves, essentially function as one-way valves that operate in sync with the pumping heart. The valves allow blood to flow downstream but obstruct blood flow upstream. Affected heart valves exhibit dysfunctions such as valve stenosis or regurgitation, which impede the valve's ability to control blood flow. Such dysfunctions reduce the heart's blood-pumping efficiency and can lead to debilitating, life-threatening conditions. For example, valve failure can lead to conditions such as cardiac hypertrophy and ventricular dilation. Therefore, extensive attempts have been made to develop methods and devices for repairing or replacing dysfunctional heart valves.

[0004] Prostheses exist to correct the problems associated with dysfunctional heart valves. For example, mechanical and tissue-based heart valve prostheses can be used to replace dysfunctional native heart valves. More recently, substantial efforts have been devoted to developing replacement heart valves, particularly tissue-based replacement heart valves that can be delivered less traumatically to patients rather than through open-heart surgery. Replacement valves are designed to be delivered through minimally invasive procedures, and even percutaneous procedures. Such replacement valves often comprise a tissue-based valve body coupled to an expandable frame that is subsequently delivered to the annulus of the native valve.

[0005] These replacement valves are often intended to at least partially obstruct blood flow. However, problems arise when blood flows around the valve outside the prosthesis. For example, paravalvular leakage has proven particularly challenging in the context of replacement heart valves. Further difficulties relate to the ability of such prostheses to be secured in an atraumatic manner to tissue within a lumen, for example, tissue within a body lumen or cavity. Further difficulties arise when attempting to controllably deliver and secure such prostheses to a location such as the native mitral valve. These replacement valves are often intended to at least partially obstruct blood flow.

[0006] Due to the drawbacks associated with traditional open-heart surgery, percutaneous and minimally invasive surgical approaches have attracted considerable attention. In one technique, prosthetic valves are configured to be implanted in a much less invasive procedure using catheterization. For example, U.S. Patent Nos. 5,629,999 and 5,729,999, incorporated herein by reference, describe a collapsible transcatheter heart valve that can be introduced percutaneously in a compressed state in a catheter and expanded at a desired location by balloon inflation or by the use of a self-expanding frame or stent. In yet another example, U.S. Patent Nos. 5,629,999; 5,729,999; 5,729,999; and 5,729,999, incorporated herein by reference in their entireties, describe a heart valve prosthesis for replacing a native mitral valve that is designed to be deployed within a body cavity and includes a self-expanding frame with multiple anchoring members that prevent axial flow of fluid around the exterior of the prosthesis.

[0007] However, the fabrication of such implantable devices is cumbersome, expensive, and often limiting. For example, textiles used as part of materials for sealing paravalvular leaks are often formed from woven or knitted fabrics containing filaments of medical-grade polyester (PET). The processing required to fabricate such fabrics is time-consuming, and the resulting products have several limitations. For example, the PET filaments used for such structures are limited to relatively large diameter filaments. Currently, the minimum applicable diameter of PET filaments is approximately 10 microns, which can affect other properties of the resulting fabric, such as the surface area, surface smoothness, and tensile properties of the knitted fabric. Additionally, PET-based knitted fabrics are not biodegradable and / or bioabsorbable, further limiting the use of such fabrics.

[0008] Also, manufacturing other components of the valve presents additional challenges and limitations. For example, the leaflets of the valve are often formed from materials derived from living tissue, which makes such fabrication more complex and expensive. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] U.S. Patent No. 5,411,522 [Patent Document 2] U.S. Patent No. 6,730,118 [Patent Document 3] US Patent Application Publication No. 2014 / 0277390 [Patent Document 4] US Patent Application Publication No. 2014 / 0277422 [Patent Document 5] US Patent Application Publication No. 2014 / 0277427 [Patent Document 6] US Patent Application Publication No. 2015 / 0328000 [Patent Document 7] US Patent Application Publication No. 2019 / 0328515 [Patent Document 8] International Publication No. 2015 / 070249 [Patent Document 9] US Patent Application Publication No. 2017 / 0325976 [Patent Document 10] U.S. Patent No. 8,641,757 [Patent Document 11] US Patent Application Publication No. 2018 / 0153689 [Patent Document 12] US Patent Application Publication No. 2019 / 0046314 [Patent Document 13] U.S. Patent No. 7,393,360 [Patent Document 14] U.S. Patent No. 7,510,575 [Patent Document 15] U.S. Patent No. 7,993,394 [Patent Document 16] U.S. Patent No. 8,652,202 [Patent Document 17] US Patent Application Publication No. 2018 / 0325661 [Patent Document 18] U.S. Patent Application No. 62 / 882,352 [License 19] U.S. Patent and Trademark Publication No. 2010 / 0193999 [Patent Document 20] U.S. Patent No. 9410267 [Non-licensed literature]

[0010] [Non-licensed Document 1] R. Nawalakheら, Journal of Fiber Bioengineering & Informatics, 5:3 (2012) 227~242 [Non-licensed Document 2] H. Niuら, J. of Nanomaterials, 2012, https: / / doi.org / 10.1155 / 2012 / 725950 [Non-licensed Document 3] WH Zhouら, ACS Appl. Mater. Inter. 9 (2017), 25830~25846 [Non-licensed Document 4] J. Duら, App. Surf. Sci., 447 (2018), 269~278 [Non-licensed Document 5] J. Brown, Acta Biomater. 11 (2015), 212~221 [Non-licensed Document 6] ID Kohら, Prog. Polym. Sci. 46 (2015), 86~110 [Non-licensed Document 7] YF Fengら, ACS Sustain. Chem. Eng. 5 (2017), 6227~6236 [Non-licensed Document 8] F. Teuleら、Proc. Natl. Acad. Sci. USA 109 (1012) 923~928 [Non-licensed Document 9] A. Teimouri, Polym. Degrad. Stabil. 121 (2015), 18~29 [Non-licensed Document 10] FM Miroiu et al., Appl. Surf. Sci. 355 (2015), 1123~1131 [Non-Patent Document 11] https: / / www.hindawi.com / journals / jnm / 2012 / 725950 / Summary of the Invention [Problem to be solved by the invention]

[0011] Thus, there remains a need for implantable devices comprising materials with desirable mechanical and chemical properties that are easy to manufacture. These and other needs are met, at least in part, by the present disclosure. [Means for solving the problem]

[0012] Some aspects of the present disclosure relate to implantable prosthetic valves. One aspect relates to an implantable prosthetic valve comprising: an annular frame having inner and outer surfaces, an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; a leaflet structure positioned within the frame; an inner skirt positioned along the inner surface of the frame; and at least one outer skirt positioned around the outer surface of the frame, wherein at least a portion of one of the leaflet structure, the inner skirt, or the at least one outer skirt comprises a material including a plurality of fibers, and at least one fiber of the plurality of fibers comprises electrospun silk, and the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0013] In yet another aspect, disclosed is an implantable prosthetic valve in which at least a portion of the inner skirt comprises a material comprising a plurality of fibers comprising electrospun silk, and the material present in at least a portion of the inner skirt is a first material. In one aspect, disclosed is an implantable prosthetic valve of the previous aspect, in which at least a portion of the outer skirt comprises a material comprising a plurality of fibers comprising electrospun silk, and the material present in at least a portion of the outer skirt is a second material. In yet another aspect, disclosed is an implantable prosthetic valve of the previous aspect, in which at least a portion of the leaflet structure comprises a material comprising a plurality of fibers comprising electrospun silk, and the material present in at least a portion of the leaflet structure is a third material. Also disclosed herein are aspects in which the first material, second material, and third material are the same or different.

[0014] Also disclosed herein are embodiments in which each fiber of the plurality of fibers has a first extension direction and a plurality of undulations. In some embodiments, the first extension direction can include a circumferential direction, a radial direction, or a combination thereof. In still further embodiments, the described plurality of undulations can be present in a collapsed configuration. In still further embodiments, the plurality of undulations can be configured to straighten when the implantable prosthetic valve is in an expanded configuration.

[0015] In one aspect, disclosed is an implantable prosthetic valve, wherein the valve further includes an adhesive material disposed between at least a portion of the annular frame and at least a portion of the outer skirt and / or between at least a portion of the annular frame and at least a portion of the inner skirt. While in another aspect, disclosed is an implantable prosthetic valve, wherein at least a portion of the inner skirt is attached to the annular frame by direct electrospinning of a plurality of fibers onto at least a portion of the inner surface of the annular frame. In yet a further aspect, disclosed is an implantable prosthetic valve, wherein at least a portion of the outer skirt is attached to at least a portion of the annular frame by direct electrospinning of a plurality of fibers onto at least a portion of the outer surface of the annular frame.

[0016] Still further, there is disclosed the implantable prosthetic valve of any one of the preceding aspects, wherein at least a portion of the plurality of fibers has a random orientation, while in other aspects, at least a portion of the plurality of fibers can have a predetermined side-by-side orientation.

[0017] In some exemplary embodiments, the plurality of fibers may further comprise a material other than silk. In some exemplary embodiments, the plurality of fibers may further comprise an absorbable material, a non-absorbable material, or any combination thereof. For example, in some embodiments, the plurality of fibers may further comprise thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0018] Still further disclosed are embodiments in which at least a portion of the plurality of fibers comprise bicomponent fibers. In such exemplary embodiments, it is understood that the bicomponent fibers can have a side-by-side configuration, a sheath-core configuration, an islands-in-the-sea configuration, a trilobal configuration, a split-pie configuration, or any combination thereof. While in one exemplary, non-limiting embodiment, the bicomponent fibers can have a sheath-core configuration.

[0019] In some embodiments, the sheath and / or core of the bicomponent fiber comprises an absorbable material, a non-absorbable material, or any combination thereof. In certain embodiments, the sheath of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. and the core of the bicomponent fiber can comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.However, in still further exemplary embodiments, the sheath of the bicomponent fiber can comprise silk, while the core of the bicomponent fiber can include one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0020] Also disclosed herein are embodiments in which the plurality of fibers can have an average diameter of about 3 nm to about 15,000 nm. While in other embodiments, at least a portion of the first material, the second material, and / or the third material can exhibit porosity. In such exemplary, non-limiting embodiments, at least a portion of the first material, the second material, and / or the third material can have an average pore size of about 100 nm to about 100 μm. In still further embodiments, the first material, the second material, and / or the third material can include multiple layers, each of the multiple layers comprising electrospun silk and disposed one on top of the other. In such exemplary embodiments, at least a first portion of the multiple layers has a surface area substantially smaller than the surface area of ​​a second portion of the multiple layers.

[0021] In still further embodiments, the first material, second material, and / or third material used in any of the above-disclosed implantable prosthetic devices can exhibit a tensile strength of greater than 0 MPa to about 20 MPa, while in other embodiments, the first material, second material, and / or third material can exhibit an elongation at break of greater than 0% to about 600%. In still further embodiments, the first material, second material, and / or third material can exhibit a water contact angle of about 0° to about 180°.

[0022] Also disclosed are embodiments in which at least a portion of the annular frame is surface-modified. In certain non-limiting embodiments, at least a portion of the annular frame is plasma-treated, while in other embodiments, at least a portion of the inner skirt may be surface-modified. In such exemplary embodiments, at least a portion of the inner skirt comprising a first material is plasma-treated, while in still further embodiments, at least a portion of the outer skirt may be surface-modified. In such exemplary embodiments, at least a portion of the outer skirt comprising a second material may be plasma-treated. Still further, in some embodiments, at least a portion of the leaflet system may also be surface-modified. In such exemplary embodiments, at least a portion of the leaflet structure comprising a third material is plasma-treated.

[0023] Further disclosed herein are embodiments in which the first material, the second material, and / or the third material are at least partially biodegradable, while in other embodiments, the first material, the second material, and / or the third material are at least partially bioabsorbable. In still further embodiments, the first material, the second material, and / or the third material can be both at least partially biodegradable and at least partially bioabsorbable. In still further embodiments, the first material, the second material, and / or the third material as described in any of the previous embodiments can be at least partially degradable. In still further embodiments, the first material, the second material, and / or the third material as described in any of the previous embodiments can be a scaffold material.

[0024] In still further aspects, the implantable valves disclosed herein can have at least a portion of the inner skirt further comprising a first perforated material having a first surface facing the annular frame and an opposing second surface, wherein the first material, which can include a plurality of fibers including electrospun silk, is disposed on the first surface and / or the second surface of the first perforated material.

[0025] In still other embodiments, at least a portion of the outer skirt can further include a second perforated material having a first surface facing the annular frame and an opposite second surface, and the second material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or the second surface of the second perforated material.

[0026] Also disclosed is an embodiment in which at least a portion of the leaflet structure includes a third porous material having a first surface facing the annular frame and an opposing second surface, and the third material including a plurality of fibers including electrospun silk is disposed on the first surface and / or the second surface of the third porous material.

[0027] Additionally or alternatively, also disclosed are embodiments in which at least a portion of the leaflet structure includes a third porous material having a first surface facing the annular frame and an opposing second surface, and the third material including a plurality of fibers including electrospun silk is disposed on the first surface and / or the second surface of the third porous material.

[0028] Still further, in some embodiments, the first perforated material, the second perforated material, and / or the third perforated material can be the same or different.

[0029] Also disclosed are embodiments in which at least a portion of a first surface of the first material includes a first auxiliary layer, while in alternative or additional embodiments, at least a portion of a second surface of the first material includes a first auxiliary layer.

[0030] In one aspect, disclosed is an implantable prosthetic valve in which a first auxiliary layer present on a second surface of a first material is the same as or different from a first auxiliary layer present on a first surface of the first material.

[0031] In still other embodiments, at least a portion of the first surface of the second material includes a second auxiliary layer.

[0032] Still further disclosed are embodiments in which at least a portion of the second surface of the second material includes a second auxiliary layer.

[0033] Also disclosed is an embodiment in which the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0034] Still further disclosed are embodiments in which at least a portion of a first surface of the third material includes a third auxiliary layer, while in other embodiments, at least a portion of a second surface of the third material includes a third auxiliary layer.

[0035] In still further embodiments, the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0036] While in still further embodiments, each of the first sub-layer, second sub-layer, or third sub-layer can be the same or different.

[0037] In some embodiments, the first perforated material, the second perforated material, and / or the third perforated material can comprise a porous fabric or membrane, wherein the porous fabric or membrane comprises: Absorbency , Non-absorbable , or combinations thereof. In one exemplary non-limiting embodiment, the first porous material, the second porous material, and / or the third porous material can comprise a porous braid or membrane, wherein the porous braid or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA), or combinations thereof, or natural / regenerated fibers selected from cotton, silk, hemp, cellulose acetate, collagen, or combinations thereof.

[0038] In still other aspects, the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are configured to impart hydrophobicity, hydrophilicity, elasticity, mechanical recovery, adhesiveness, tissue ingrowth inhibition, or any combination thereof to at least a portion of the first material, the second material, and / or the third material.

[0039] In still further embodiments, the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises: Absorbency material, Non-absorbableAdditionally or alternatively, also disclosed are embodiments in which the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprise one or more of thermoplastic polyurethane (TPU), polyurethane (PU), an implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0040] In certain further embodiments, at least a portion of the inner skirt further comprises at least two layers of a first porous material, wherein the first material comprising a plurality of fibers comprising electrospun silk is disposed between the two layers of the first porous material, and the two layers of the first porous material are at least partially bonded to one another.

[0041] While in other embodiments, at least a portion of the outer skirt can further comprise at least two layers of a second porous material, wherein the second material comprising a plurality of fibers comprising electrospun silk is disposed between the two layers of the second porous material, and the two layers of the second porous material are at least partially bonded to each other.

[0042] Also disclosed is an embodiment in which at least a portion of the leaflet structure further comprises at least two layers of a third porous material, wherein the third material comprises a plurality of fibers comprising electrospun silk, and the two layers of the third porous material are at least partially bonded to each other.

[0043] In still further embodiments, at least a portion of the second surface of the first material is disposed on the first surface of the first porous material, while in other embodiments, at least a portion of the first surface of the first material is disposed on the second surface of the first porous material, and in still further embodiments, at least a portion of the second surface of the second material is disposed on the first surface of the second porous material.

[0044] In still further exemplary non-limiting embodiments, at least a portion of the first surface of the second material is disposed on the second surface of the second porous material. In still other embodiments, at least a portion of the second surface of the third material is disposed on the first surface of the third porous material.

[0045] In some embodiments, at least a portion of the first surface of the third material is disposed on the second surface of the third porous material.

[0046] While in other embodiments, at least a portion of the first auxiliary layer and the first perforated material are bonded to one another.

[0047] Still further disclosed are embodiments in which at least a portion of the second auxiliary layer and the second perforated material are bonded to one another, while in other embodiments, at least a portion of the third auxiliary layer and the third perforated material are bonded to one another.

[0048] Also disclosed herein, in certain embodiments, is an article comprising a material including a plurality of fibers, at least one of which comprises electrospun silk, the article having a collapsed configuration and an expanded configuration, and the article being part of an implantable device. In such exemplary embodiments, the article is a perivalvular leak sealing article. In still further embodiments, the perivalvular leak sealing article can include an inner skirt including a first material including a plurality of fibers including electrospun silk, the inner skirt configured to be positioned on at least a portion of the inner surface of an annular frame of an implantable prosthetic device, the first material having a first surface facing the annular frame and an opposing second surface. Meanwhile, in still further embodiments, the perivalvular leak sealing article can include an outer skirt including a second material including a plurality of fibers including electrospun silk, the outer skirt configured to be positioned on at least a portion of the outer surface of an annular frame of an implantable prosthetic device, the second material having a first surface facing the annular frame and an opposing second surface.

[0049] Still further disclosed herein is an embodiment in which an article can include a valve leaflet structure including a third material including a plurality of fibers including electrospun silk, the valve leaflet structure being configured to be positioned within at least a portion of an annular frame of an implantable prosthetic device, the third material having a first surface facing the annular frame and an opposing second surface. In the embodiments disclosed herein, it is understood that the disclosed material includes the first material, the second material, the third material, or a combination thereof. In still further embodiments disclosed herein, the first material, the second material, and the third material can be the same or different.

[0050] In still further embodiments, each fiber of the plurality of fibers has a first extension direction and a plurality of undulations. Moreover, in such exemplary embodiments, the first extension direction can include a circumferential direction, a radial direction, or a combination thereof. Still further, the plurality of undulations, as described in any previous embodiment, are present in the collapsed configuration. In such embodiments, it is further understood that the plurality of undulations are configured to straighten when the article is in the expanded configuration.

[0051] In certain embodiments, at least a portion of the inner skirt is attached to at least a portion of the annular frame by direct electrospinning of a plurality of fibers, while in other exemplary embodiments, at least a portion of the outer skirt is attached to at least a portion of the annular frame by direct electrospinning of a plurality of fibers.

[0052] Also disclosed is a method for fabricating a plurality of fibers comprising: Absorbency material, Non-absorbableThe article further comprises a material, or a combination thereof. In some embodiments, at least a portion of the plurality of fibers have a random orientation, while in other embodiments, at least a portion of the plurality of fibers have a predetermined side-by-side orientation. In such embodiments, the article disclosed in any of the previous embodiments can also comprise a plurality of fibers, wherein the plurality of fibers further comprises thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0053] In still further exemplary embodiments, at least a portion of the plurality of fibers can comprise bicomponent fibers. It is understood that the bicomponent fibers can have any known configuration. In one exemplary, non-limiting embodiment, the bicomponent fibers can have a side-by-side configuration, a sheath-core configuration, a trilobal configuration, an islands-in-the-sea configuration, a split-pie configuration, or any combination thereof. While in one embodiment, the bicomponent fibers have a sheath-core configuration.

[0054] In certain embodiments, the sheath and / or core of the bicomponent fiber comprises: Absorbency material, Non-absorbableIn still other embodiments, the sheath of the bicomponent fiber may comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. and the core of the bicomponent fiber can comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0055] In yet further exemplary embodiments, the sheath of the bicomponent fiber can comprise silk, while the core of the bicomponent fiber can comprise one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(esterurethane)urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0056] In still further embodiments, the article can include a plurality of fibers, as described in any previous embodiment, wherein the plurality of fibers has an average diameter of about 3 nm to about 15,000 nm. While in other exemplary embodiments, at least a portion of the first material, the second material, and / or the third material can exhibit porosity. While in still further exemplary embodiments, at least a portion of the first material, the second material, and / or the third material can have an average pore size of about 100 nm to about 100 μm.

[0057] Also disclosed herein are article embodiments in which at least a portion of the first material, and / or the second material, and / or the third material comprises multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers is disposed on top of one another. In such exemplary embodiments, at least a first portion of the multiple layers has a surface area that is substantially less than the surface area of ​​a second portion of the multiple layers.

[0058] Still further disclosed herein are article embodiments in which at least a portion of the first material, and / or the second material, and / or the third material can exhibit a tensile strength of greater than 0 MPa to about 20 MPa. Also disclosed herein are article embodiments in which at least a portion of the first material, and / or the second material, and / or the third material can exhibit an elongation at break of greater than 0% to about 600%. In still further embodiments, at least a portion of the first material, and / or the second material, and / or the third material can exhibit a water contact angle of about 0° to about 180°. It is understood that also disclosed herein are article embodiments in which at least a portion of the first material, and / or the second material, and / or the third material can exhibit the tensile strength, elongation, and / or water contact angle previously disclosed.

[0059] In yet a further aspect, disclosed herein is an article as described in any one of the preceding aspects, wherein at least a portion of the first material, the second material, and / or the third material is surface-modified by any art-known method. In one exemplary embodiment, at least a portion of the first material comprising a plurality of fibers is plasma-treated. While in another exemplary embodiment, at least a portion of the second material is plasma-treated. While in yet another exemplary embodiment, at least a portion of the third material is plasma-treated.

[0060] In certain embodiments, at least a portion of the first material, and / or the second material, and / or the third material may be at least partially biodegradable. While in other embodiments, at least a portion of the first material, and / or the second material, and / or the third material may be at least partially bioabsorbable. While in still further embodiments, at least a portion of the first material, and / or the second material, and / or the third material may be at least partially degradable. However, it is understood that also disclosed herein are embodiments in which at least a portion of the first material, and / or the second material, and / or the third material is at least partially biodegradable, at least partially bioabsorbable, and / or at least partially degradable. In still further embodiments, at least a portion of the first material, and / or the second material, and / or the third material as described in any of the previous embodiments may also be configured to be a scaffold material.

[0061] Also disclosed herein is an article, wherein at least a portion of the inner skirt further comprises a first perforated material having a first surface facing the annular frame and an opposing second surface, and wherein the first material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or the second surface of the first perforated material.

[0062] In still a further aspect, disclosed is an article wherein at least a portion of the outer skirt further comprises a second perforated material having a first surface facing the annular frame and an opposing second surface, and wherein the second material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or the second surface of the second perforated material.

[0063] Also disclosed is an article in which at least a portion of the leaflet structure includes a third porous material having a first surface facing the annular frame and an opposing second surface, and a third material including a plurality of fibers including electrospun silk is disposed on the first surface and / or the second surface of the third porous material.

[0064] In certain additional or alternative embodiments, the first perforated material, the second perforated material, and / or the third perforated material may be the same or different.

[0065] While in still other embodiments, disclosed are articles in which at least a portion of a first surface of a first material comprises a first auxiliary layer. While in still other embodiments, at least a portion of a second surface of the first material comprises a first auxiliary layer. Also disclosed are articles in which the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0066] Additionally or alternatively, disclosed are articles in which at least a portion of a first surface of a second material comprises a second auxiliary layer. In certain exemplary embodiments, at least a portion of the second surface of the second material comprises a second auxiliary layer. In still further embodiments, the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0067] Additionally or alternatively, disclosed are articles in which at least a portion of a first surface of a third material comprises a third auxiliary layer. In certain exemplary embodiments, at least a portion of a second surface of the third material comprises a third auxiliary layer. In still further embodiments, the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0068] Still further, each of the first sub-layer, second sub-layer, or third sub-layer can be the same or different.

[0069] Also disclosed herein is a method for manufacturing a membrane-based membrane, wherein the first perforated material, the second perforated material, and / or the third perforated material comprises a porous fabric or membrane, the porous fabric or membrane comprising: Absorbency material, Non-absorbableIn still other embodiments, the first porous material, the second porous material, and / or the third porous material comprises a porous knit or membrane, wherein the porous knit or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA), or a combination thereof, or a natural / regenerated fiber selected from cotton, silk, hemp, cellulose acetate, collagen, or a combination thereof.

[0070] Additionally or alternatively, disclosed are articles wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are configured to impart hydrophobic or hydrophilic properties, elasticity, mechanical recovery, adhesive properties, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first material, the second material, and / or the third material.

[0071] In yet a further aspect, what is disclosed is a method for preparing a coating composition comprising: Absorbency material, Non-absorbable In still other embodiments, the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises one or more of a thermoplastic polyurethane (TPU), a polyurethane (PU), an implantable elastane polymer, or a polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), a polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0072] Also disclosed is an article wherein at least a portion of the inner skirt further comprises at least two layers of a first perforated material, wherein the first material comprising a plurality of fibers comprising electrospun silk is disposed between the two layers of the first perforated material, and wherein the two layers of the first perforated material are at least partially bonded to one another.

[0073] In one embodiment, disclosed is an article wherein at least a portion of the outer skirt further comprises at least two layers of a second porous material, wherein the second material comprising a plurality of fibers comprising electrospun silk is disposed between the two layers of the second porous material, and wherein the two layers of the second porous material are at least partially bonded to one another.

[0074] However, in other aspects, disclosed are articles wherein at least a portion of the leaflet structure further comprises at least two layers of a third porous material, wherein the third material comprising a plurality of fibers comprising electrospun silk is disposed between the two layers of the third porous material, and wherein the two layers of the third porous material are at least partially bonded to one another.

[0075] In certain exemplary, non-limiting embodiments, disclosed are articles in which at least a portion of the second surface of a first material is disposed on a first surface of a first porous material. In yet other embodiments, at least a portion of the first surface of a first material is disposed on a second surface of a first porous material.

[0076] In still further embodiments, at least a portion of the second surface of the second material is disposed on the first surface of the second porous material, while in other embodiments, at least a portion of the first surface of the second material is disposed on the second surface of the second porous material, while in still further embodiments, at least a portion of the second surface of the third material is disposed on the first surface of the third porous material.

[0077] Also disclosed are embodiments directed to an article having at least a portion of a first surface of a third material disposed on a second surface of a third perforated material.

[0078] In some embodiments, at least a portion of the first auxiliary layer and the first perforated material are bonded to one another, while in other embodiments, at least a portion of the second auxiliary layer and the second perforated material are bonded to one another, while in still further embodiments, at least a portion of the third auxiliary layer and the third perforated material are bonded to one another.

[0079] Also disclosed herein is a method of forming an implantable prosthetic valve. In such an embodiment, the method includes the steps of: a) providing an annular frame having an inner surface and an outer surface, the frame having an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; b) forming an inner skirt comprising a first material having a first surface and an opposite second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; c) forming an outer skirt comprising a second material having a first surface and an opposite second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; and d) attaching the inner skirt to at least a portion of the inner surface of the annular frame and the outer skirt to at least a portion of the outer surface of the annular frame, wherein the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0080] In some aspects, the steps of forming the inner skirt and attaching the inner skirt may occur simultaneously, while in yet other aspects, the step of forming the inner skirt may occur before the step of attaching.

[0081] Additionally or alternatively, disclosed are methods in which the steps of forming the outer skirt and attaching the outer skirt occur simultaneously, while in other aspects the step of forming the outer skirt may occur before the attaching step.

[0082] In some methods, the step of attaching the inner skirt occurs before or after the step of attaching the outer skirt.

[0083] Additionally or alternatively, the methods disclosed herein further include positioning a leaflet structure comprising a third material having a first surface and an opposing second surface, and comprising a plurality of fibers, wherein at least one fiber of the plurality of fibers comprises electrospun silk within at least a portion of the annular frame.

[0084] For some applications, the step of positioning the leaflet structure may occur before or after the step of forming the inner and / or outer skirt.

[0085] Also disclosed are methods in which the first material, second material, and third material are the same or different.

[0086] Alternatively or additionally, disclosed is a method wherein the step of forming the inner skirt and simultaneously attaching the inner skirt to at least a portion of the inner surface of the annular frame includes forming a first material on at least a portion of the inner surface of the annular frame by directly electrospinning at least a portion of a plurality of fibers from a first solution comprising silk fibroin at a first predetermined concentration through at least one spinneret at a predetermined extrusion rate.

[0087] In a further aspect, disclosed is a method wherein forming the first material comprises electrospinning at least a portion of a plurality of fibers from a first solution comprising silk fibroin at a first predetermined concentration through at least one spinneret at a first predetermined mandrel and a predetermined extrusion rate.

[0088] Also disclosed is a method in which the attaching step includes the steps of: i) forming a first material to predetermined dimensions; and ii) attaching the first material to at least a portion of an inner surface of an annular frame.

[0089] Additionally or alternatively, disclosed is a method in which the step of forming the outer skirt and simultaneously attaching the outer skirt to at least a portion of the outer surface of the annular frame includes forming a second material on at least a portion of the outer surface of the annular frame by directly electrospinning at least a portion of the plurality of fibers from a second solution comprising silk fibroin at a second predetermined concentration through at least one spinneret at a predetermined extrusion rate.

[0090] In yet another aspect, forming the second material includes electrospinning at least a portion of the plurality of fibers through at least one spinneret from a second solution comprising silk fibroin at a second predetermined concentration on a second predetermined mandrel at a predetermined extrusion rate.

[0091] Additionally or alternatively, disclosed is a method wherein the attaching step includes: i) forming the second material to predetermined dimensions; and ii) attaching the second material to at least a portion of an outer surface of the annular frame.

[0092] In yet a further method, the third material can be formed by electrospinning a plurality of fibers from a third solution comprising a third predetermined concentration of silk fibroin at a predetermined extrusion rate on a third predetermined mandrel. In one method, the third material can be laser cut to form the valve leaflet structure.

[0093] In one exemplary non-limiting method, at least a portion of the annular frame is plasma treated prior to forming the inner and / or outer skirt, while in another method, an adhesive material is applied to at least a portion of the inner and / or outer surface of the annular frame prior to attaching the inner and / or outer skirt to at least a portion of the inner and / or outer surface of the annular frame, respectively.

[0094] In certain embodiments in addition to or in the alternative to any one of the preceding embodiments, at least a portion of the inner surface of the annular frame can be positioned a first predetermined distance from the at least one extrusion spinneret during electrospinning of at least a portion of the plurality of fibers to form the first material. In yet other embodiments, at least a portion of the outer surface of the annular frame can be positioned a second predetermined distance from the at least one extrusion spinneret during electrospinning of at least a portion of the plurality of fibers to form the second material.

[0095] In certain exemplary embodiments, at least one extrusion spinneret is positioned outside the annular frame.

[0096] While in other embodiments, the at least one extrusion spinneret is positioned within at least a portion of the interior space of the annular frame, the interior space being defined by the periphery of the inner surface of the annular frame. In such exemplary non-limiting embodiments, the method further comprises at least one additional extrusion spinneret positioned outside the annular frame.

[0097] In such exemplary methods, electrospinning may occur simultaneously from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and from at least one additional spinneret positioned outside the annular frame, while in other methods, electrospinning may occur first from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and then from at least one additional spinneret positioned outside the annular frame.

[0098] In still other methods, electrospinning can occur first from at least one additional spinneret positioned outside the annular frame, and then from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame. In still further embodiments, electrospinning is performed in a cyclical fashion.

[0099] In some embodiments, the at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and the at least one additional spinneret positioned outside the annular frame have the same or different extrusion rates, while in other embodiments, the at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and the at least one additional spinneret positioned outside are each configured to electrospin a plurality of fibers from solutions having the same or different concentrations of silk fibroin.

[0100] Also disclosed is a method in which at least one extrusion spinneret is positioned within at least a portion of the interior space of the annular frame at a third distance from the annular frame and configured to be moved within the interior space of the annular frame. In a still further aspect, the third predetermined distance from the annular frame is adjustable.

[0101] In some embodiments, at least one additional spinneret positioned outside the annular frame is positioned a fourth predetermined distance from the annular frame. In still further embodiments, the fourth predetermined distance from the annular frame is adjustable. In still further embodiments, the first predetermined distance, the second predetermined distance, the third predetermined distance, and / or the fourth predetermined distance are the same or different.

[0102] In one aspect, disclosed is a method in which a plurality of fibers formed by at least one extrusion spinneret positioned within at least a portion of the interior space of an annular frame and at least one additional spinneret positioned outside the annular frame are consolidated.

[0103] In an additional and non-limiting embodiment, during electrospinning of at least a portion of the plurality of fibers to form the third material, at least a portion of the third predetermined mandrel can be positioned a third predetermined distance from the at least one extrusion spinneret.

[0104] Also disclosed is that during electrospinning of at least a portion of the plurality of fibers to form the first material, and / or the second material, and / or the third material, at least a portion of the inner surface of the annular frame and / or at least a portion of the outer surface of the annular frame and / or at least a portion of the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel are positioned a distance from at least one extrusion spinneret, and the distance is changed during electrospinning to form one or more layers within at least a portion of the first material, the second material, and / or the third material.

[0105] In some methods, at least a portion of the annular frame is positioned on a rotating drum configured to rotate at a predetermined speed, while in other methods, the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel are configured to rotate or to be stationary.

[0106] Also disclosed is a method in which a first predetermined voltage is applied between a rotating drum and at least one spinneret. In yet another aspect, a second predetermined voltage is applied between the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel and at least one spinneret.

[0107] In some methods, at least one spinneret comprises a needle.

[0108] In still other methods, at least one spinneret is part of an assembly that includes multiple spinnerets. In such an exemplary, non-limiting method, the assembly can include multiple needleless spinnerets.

[0109] Also disclosed are methods in which the plurality of fibers present in the first material, the second material, and / or the third material include a first extension direction and a plurality of undulations. In such exemplary methods, the first extension direction can include a circumferential direction, a radial direction, or a combination thereof. In still further embodiments, the plurality of undulations is present in the collapsed configuration of the implantable prosthetic valve, while in other embodiments, the plurality of undulations is configured to straighten when the implantable prosthetic valve is in the expanded configuration.

[0110] In some methods, at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material have a random orientation, while in other methods, at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material have a predetermined side-by-side orientation.

[0111] Additionally or alternatively, what is disclosed is that the plurality of fibers present in the first material, and / or the second material, and / or the third material are: Absorbency material, Non-absorbable In still other methods, the plurality of fibers present in the first material, the second material, and / or the third material further comprise thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0112] In one method, the plurality of fibers are Absorbency material, Non-absorbableThe fibers are deposited by electrospinning through at least one spinneret from a first solution, a second solution, and / or a third solution further comprising a material, or a combination thereof. In one such exemplary, non-limiting embodiment, a plurality of fibers are deposited by electrospinning through at least one spinneret at a predetermined extrusion rate from a first solution, a second solution, and / or a third solution further comprising a predetermined concentration of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0113] While in other approaches, at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material comprise bicomponent fibers, and in such example, non-limiting approaches, the bicomponent fibers comprise a side-by-side configuration, a sheath-core configuration, a trilobal configuration, an islands-in-the-sea configuration, a split-pie configuration, or any combination thereof.

[0114] In some embodiments, the bicomponent fiber can have a sheath-core configuration. For example, it is disclosed that the sheath and core of the bicomponent fiber can be: Absorbency material, Non-absorbableIn still other methods, the sheath of the bicomponent fiber is made of one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. The core of the bicomponent fiber may include one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0115] Also disclosed, however, is a method in which the sheath of the bicomponent fiber comprises silk and the core of the bicomponent fiber comprises one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0116] In one embodiment, the composite fiber is deposited by electrospinning through at least two concentric spinnerets, the outer spinneret configured to extrude sheath fibers from a fourth solution comprising a fourth predetermined concentration of silk fibroin, and the inner spinneret configured to extrude sheath fibers from a fourth solution comprising a fourth predetermined concentration of silk fibroin. Absorbency material, Non-absorbable The method is configured to extrude the core fiber from a fifth solution containing the material, or a combination thereof. In one such exemplary, non-limiting embodiment, a composite fiber can be deposited by electrospinning through at least two concentric spinnerets, the outer spinneret configured to extrude a sheath fiber from a fourth solution comprising a fourth predetermined concentration of silk fibroin, and the inner spinneret configured to extrude a core fiber at a predetermined extrusion rate from a fifth solution comprising a predetermined concentration of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0117] Also disclosed is a method, wherein the plurality of fibers present in the first material, and / or the second material, and / or the third material have an average diameter of about 3 nm to about 15,000 nm.

[0118] In some methods, at least a portion of the first material, the second material, and / or the third material exhibits porosity. In such exemplary methods, at least a portion of the first material, the second material, and / or the third material has an average pore size of about 100 nm to about 100 μm.

[0119] Additionally or alternatively, disclosed are methods wherein the first material, and / or the second material, and / or the third material comprise multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers being disposed on top of one another.

[0120] In one embodiment, disclosed is a method wherein at least a first portion of the plurality of layers has a surface area that is substantially less than a surface area of ​​a second portion of the surface area of ​​the plurality of layers.

[0121] In yet another aspect, disclosed is a method wherein the first material, and / or the second material, and / or the third material exhibit a tensile strength of greater than 0 MPa to about 20 MPa. In yet a further aspect, the first material, and / or the second material, and / or the third material can exhibit an elongation at break of greater than 0% to about 600%, while in yet a further aspect, the first material, and / or the second material, and / or the third material exhibits a water contact angle of about 0° to about 180°.

[0122] In some embodiments, at least a portion of the first material, the second material, and / or the third material is biodegradable. In still other embodiments, at least a portion of the first material, the second material, and / or the third material is bioabsorbable. In still other embodiments, at least a portion of the first material, the second material, and / or the third material is degradable. While in still further embodiments, at least a portion of the first material, the second material, and / or the third material is configured to be a scaffold material.

[0123] In certain additional or alternative embodiments, at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material are plasma treated after electrospinning.

[0124] Also disclosed is an embodiment in which at least a portion of the formed first material is disposed on a first porous material having a first surface and an opposite second surface prior to the attaching step, and the first material is disposed on the first surface and / or the second surface of the first porous material.

[0125] In some methods disclosed herein, the attaching step includes bonding a first surface of the first perforated material to at least a portion of the annular frame.

[0126] While in other methods, at least a portion of the formed second material is disposed on a second perforated material having a first surface and an opposite second surface prior to the attaching step, and the second material is disposed on the first surface and / or the second surface of the second perforated material. In such exemplary non-limiting methods, the attaching step includes bonding the first surface of the second perforated material to at least a portion of the annular frame.

[0127] Also disclosed are methods in which at least a portion of the leaflet structure is disposed in a third porous material having a first surface and an opposing second surface, the third material being disposed on the first surface and / or the second surface of the third porous material. In such exemplary, non-limiting embodiments, it is understood that the first porous material, the second porous material, and / or the third porous material can be the same or different.

[0128] Also disclosed are methods that include disposing a first auxiliary layer on at least a portion of a first surface of a first material. For example, in some methods, the first auxiliary layer is disposed on at least a portion of a second surface of the first material. In still other methods, the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0129] Additionally or alternatively, disclosed are methods including a second auxiliary layer on at least a portion of a first surface of a second material. In certain embodiments, the methods disclosed herein include disposing the second auxiliary layer on at least a portion of the second surface of the second material. In certain exemplary, non-limiting methods, the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0130] Also disclosed is a method that includes disposing a third auxiliary layer on at least a portion of a first surface of a third material. In one embodiment, the method includes disposing a third auxiliary layer on at least a portion of a second surface of the third material.

[0131] In some methods, the third auxiliary layer present on the second surface of the third material can be the same as or different from the third auxiliary layer present on the first surface of the third material. In still further embodiments, each of the first auxiliary layer, second auxiliary layer, or third auxiliary layer can be the same or different.

[0132] Also disclosed is a method for manufacturing a cellular membrane comprising: a first porous material, a second porous material, and / or a third porous material, the first porous material comprising a porous braid or membrane; and a porous braid or membrane comprising: Absorbency material, Non-absorbable In still other methods, the first porous material, the second porous material, and / or the third porous material comprise a porous braid or membrane, and the porous braid or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA), or a combination thereof, or a natural / regenerated fiber selected from cotton, silk, hemp, cellulose acetate, collagen, or a combination thereof.

[0133] However, in other embodiments, the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are configured to impart hydrophobic or hydrophilic properties, elasticity, mechanical recovery, adhesive properties, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first material, the second material, and / or the third material.

[0134] In certain methods, the first sub-layer, the second sub-layer, and / or the third sub-layer are: Absorbency material, Non-absorbable In still other methods, the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises one or more of thermoplastic polyurethane (TPU), polyurethane (PU), an implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0135] Also disclosed are embodiments directed to methods that include disposing a first material between two layers of a first porous material, wherein the two layers of the first porous material are at least partially bonded to one another.

[0136] One aspect is directed to a method that includes a second material disposed between two layers of a second porous material, the two layers of the second porous material being at least partially bonded to one another, while another aspect is directed to a method that includes disposing a third material between two layers of a third porous material, the two layers of the third porous material being at least partially bonded to one another.

[0137] In some methods, at least a portion of the second surface of the first material is disposed on the first surface of the first porous material, while in other methods, at least a portion of the first surface of the first material is disposed on the second surface of the first porous material, and in still further methods, at least a portion of the second surface of the second material is disposed on the first surface of the second porous material.

[0138] In some embodiments, disclosed are methods in which at least a portion of a first surface of a second material is disposed on a second surface of a second porous material. In still other embodiments, at least a portion of a second surface of a third material can be disposed on a first surface of a third porous material.

[0139] In yet a further method, at least a portion of a first surface of a third material is disposed on a second surface of a third porous material.

[0140] In one method, at least a portion of the first auxiliary layer and at least a portion of the first porous material are bonded together, in a still further method, at least a portion of the second auxiliary layer and at least a portion of the second porous material are bonded together, and in a still further method, at least a portion of the third auxiliary layer and at least a portion of the third porous material are bonded together.

[0141] Additional aspects of the disclosure will be set forth in part in the detailed description, the figures, and the following claims, and in part will be derived from the detailed description or may be learned by practice of the disclosure. It is to be understood that the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the disclosure as so disclosed.

[0142] Various figures are depicted in the accompanying drawings for illustrative purposes and should not be construed as limiting the scope of the present disclosure in any way. Also, various features of different disclosed embodiments may be combined to form additional embodiments that are part of this disclosure. Numerals may be reused throughout the figures to indicate correspondence between referenced elements. However, it should be understood that the use of like numerals in association with multiple drawings does not necessarily imply similarity between the respective embodiments associated therewith. Furthermore, it should be understood that features in the respective drawings are not necessarily drawn to scale, and that the depicted sizes of those features are presented for purposes of illustrating the inventive embodiments of those features. In general, some of the depicted features may be relatively smaller than shown in certain embodiments or configurations. [Brief explanation of the drawings]

[0143] [Figure 1] FIG. 1 illustrates an example frame of an example implantable device, according to one or more embodiments. [Figure 2] FIG. 1 illustrates an exemplary outer skirt material comprising electrospun fibers, according to one or more embodiments. [Figure 3A] 1A-1D illustrate various exemplary implantable devices, according to one or more embodiments. [Figure 3B] 1A-1D illustrate various exemplary implantable devices, according to one or more embodiments. [Figure 3C] 1A-1D illustrate various exemplary implantable devices, according to one or more embodiments. [Figure 4] SEM images of silk fibroin nanofibers electrospun at concentrations of 5% (Figure 4(a)), 6% (Figure 4(b)), 7% (Figure 4(c)), 8% (Figure 4(d)), 9% (Figure 4(e)), and 10% (Figure 4(f)) in 2,2,2-trifluoroacetic acid (TFA) solvent (Source: Non-Patent Document 1). [Figure 5]FIG. 1 is a schematic diagram of an exemplary electrospinning system, according to one or more embodiments. [Figure 6] FIG. 1 is a schematic diagram of an exemplary electrospinning system, according to one or more embodiments. [Figure 7A] FIG. 1 is a schematic diagram of an exemplary electrospinning system for forming an exemplary valve leaflet system, according to one or more embodiments. [Figure 7B] 1A-1D illustrate schematics for forming an exemplary valve leaflet system, according to one or more embodiments. [Figure 8] FIG. 1 shows a schematic overview of a rotating needleless spinneret (electrospinning along the red arrow) (Non-Patent Document 2). [Figure 9] Schematic overview of a stationary needleless spinneret (electrospinning along the red arrow) (Non-Patent Document 2 [Figures 10A-10B] 10A illustrates an exemplary rotary jet spinning system for applying material to an exemplary implantable device, according to one or more embodiments, and FIG. 10B illustrates a close-up view of a storage element of the system shown in FIG. 10A, according to one or more embodiments. [Figure 11] 1A-1C illustrate an exemplary setup for forming an inner skirt and / or an outer skirt, according to one embodiment. [Figures 12A-12C] 12A shows an example layer of an example knit, FIG. 12A shows an example perforated material, FIG. 12B shows an example plurality of electrospun fibers, and FIG. 12C shows an example supplemental material according to one embodiment. [Figure 13A] 1A-1C illustrate exemplary configurations of materials in various embodiments. [Figure 13B] 1A-1C illustrate exemplary configurations of materials in various embodiments. [Figure 13C] 1A-1C illustrate exemplary configurations of materials in various embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0144] The present disclosure may be more readily understood with reference to the following detailed description, examples, drawings, and claims, as well as their preceding and subsequent descriptions. However, before the present articles, systems, and / or methods are disclosed and described, it is understood that the present disclosure is not limited to the particular or exemplary embodiments of the disclosed articles, systems, and / or methods, as these may, of course, vary, unless expressly stated otherwise. It is also understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting.

[0145] The following description of the present disclosure is provided as enabling teachings of the present disclosure in its best currently known mode. To that end, those skilled in the art will recognize and appreciate that many changes can be made to the various aspects of the disclosure described herein while still obtaining the beneficial results of the present disclosure. It will also be apparent that some of the desired benefits of the present disclosure can be obtained by selecting some of the features of the present disclosure without utilizing other features. Thus, those skilled in the art will recognize that many modifications and adaptations to the present disclosure are possible and may even be desirable in certain circumstances and are a part of this disclosure. Thus, the following description is also provided as an example of the principles of the present disclosure, not as a limitation thereof.

[0146] definition As used in this application and the claims, the singular forms "a," "an," and "the" include the plural forms unless the context clearly dictates otherwise. Thus, for example, reference to "a material" includes aspects having two or more such materials unless the context clearly dictates otherwise.

[0147] It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting. As used in the specification and claims, the term "comprising" can include embodiments "consisting of" and "consisting essentially of." Also, the term "including" means "comprising."

[0148] The terms "for example," "for example," and "such as," and their grammatical equivalents, are understood to be followed by the phrase "and without limitation," unless expressly stated otherwise.

[0149] Similarly, when values ​​are expressed as approximations, by use of the antecedent "about," it will be understood that the particular value forms another aspect. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. Unless otherwise stated, the term "about" means within 5% (e.g., within 2% or within 1%) of the particular value modified by the term "about."

[0150] Throughout this disclosure, various aspects of the present disclosure may be presented in a range format. It should be understood that the description in range format is for convenience and brevity only and should not be construed as an inflexible limitation on the scope of the present disclosure. Thus, the description of a range should be considered to explicitly disclose all possible subranges and individual numerical values ​​within that range. For example, the description of a range such as 1 to 6 should be considered to explicitly disclose subranges such as 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, 3 to 6, etc., and individual numerical values ​​within that range, such as 1, 2, 2.7, 3, 4, 5, 5.3, 6, and any whole or partial increments therebetween. This applies regardless of the breadth of the range.

[0151] As used herein, the term "composition" is intended to encompass a product containing specified ingredients in specified amounts, and any product that results directly or indirectly from the combination of specified ingredients in specified amounts.

[0152] Weight percent (wt.%) of a component is based on the total weight of the formulation or composition the component is in, unless expressly stated otherwise. As used herein, the term "optional" or "optionally" means that the subsequently described event or circumstance may or may not occur, and that the description includes instances in which the event or circumstance occurs and instances in which it does not occur.

[0153] When an element is referred to as being "connected" or "bonded" to another element, it is understood that the element can be directly connected or bonded to the other element, or that intervening elements may be present. In contrast, when an element is referred to as being "directly connected" or "directly bonded" to another element, there are no intervening elements present. Other language used to describe the relationship between elements or layers should be interpreted in a similar manner (e.g., "between" and "directly between," "adjacent to" and "directly adjacent to," "on" and "directly on").

[0154] As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items.

[0155] It is understood that terms such as "first," "second," and the like may be used herein to describe various elements, components, regions, layers, and / or sections. These elements, components, regions, layers, and / or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer, or section from another element, component, region, layer, or section. Thus, a first element, first component, first region, first layer, or first section discussed below could be referred to as a second element, second component, second region, second layer, or second section without departing from the teachings of example embodiments.

[0156] Spatially relative terms such as "below," "below," "down," "above," and "above" may be used herein for ease of description to describe the relationship of an element or feature to other elements or features as shown in the figures. It is understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures were turned over, elements described as "below" or "below" other elements or features would thereby be oriented "above" the other elements or features. Thus, the term "below" can encompass both an above and below orientation. The device may be otherwise oriented (rotated 90 degrees or at another orientation), and the spatially relative descriptions used herein would be interpreted accordingly.

[0157] The terms "fiber" and "material comprising multiple fibers" are used herein according to their broad ordinary meaning and can refer to any type of natural or synthetic substance or material that is substantially long, rather than broad, including any elongated or relatively thin, elongated, and / or thread-like, filament, cord, thread, plié, filament, rope, cord, or portion thereof. Furthermore, "fiber" or "material comprising multiple fibers" can refer to a single filament or collectively to multiple filaments. Examples of materials comprising multiple fibers according to embodiments of the present disclosure include, but are not limited to, any type of fabric, knit, or woven fabric. It is understood that in certain non-limiting embodiments, the term "material comprising multiple fibers" can refer to a fabric, knit, woven fabric, or material of interlocking fibers that can encompass or form certain features of the disclosed devices.

[0158] As used herein, the term "polyester" refers to a class of polymers containing ester functional groups in the backbone. Polyesters disclosed herein include naturally occurring chemicals, such as those found in the cuticle of plant cuticles, as well as synthetic materials fabricated through step-growth polymerization. Specific examples of polyesters include homopolymers and copolymers of polyethylene terephthalate (PET), polypropylene terephthalate (PPT), and polybutylene terephthalate (PBT), including those containing homopolymers of cyclohexanedimethanol, cyclohexanedicarboxylic acid, isophthalic acid, and the like.

[0159] The term "polyamide," as used herein, is defined as any long-chain polymer in which the linking functionality is an amide (-CO-NH-) bond. The term polyamide is further defined to include homopolymers, as well as copolymers, terpolymers, etc., and includes blends of two or more polyamides. In some embodiments, the plurality of polyamide fibers comprises one or more of nylon 6, nylon 66, nylon 10, nylon 612, nylon 12, nylon 11, or any combination thereof. In other embodiments, the plurality of polyamide fibers comprises nylon 6 or nylon 66. In yet other embodiments, the plurality of polyamide fibers comprises nylon 6. In yet a further embodiment, the plurality of polyamide fibers is nylon 66.

[0160] As defined herein, the term "polyolefin" refers to a polymer formed from simple olefins (of general formula C) as monomers. n H 2n Polyolefins refer to any grade of polymer made from polyolefins (also called alkenes, according to the present invention). In some embodiments, polyolefins include, but are not limited to, polyethylene, polypropylene, comonomers and copolymers of both, poly(1-butene), poly(3-methyl-1-butene), poly(4-methyl-1-pentene), and the like, as well as combinations or mixtures of two or more thereof.

[0161] As defined herein, the term "polyurethane" refers to any class of polymers consisting of a chain of organic units joined by carbamate (urethane, R1-O-CO-NR2-R3, where R1, R2, and R3 are the same or different) bonds.

[0162] As defined herein, the term "polyether" refers to any class of polymers consisting of chains of organic units linked by ether groups.

[0163] As defined herein, the term "polyurea" refers to any grade of polymer in which alternative monomeric units of isocyanates and amines react with each other to form urea linkages.

[0164] As used herein, the term "substantially" means that the subsequently described events or circumstances occur exactly, or that the subsequently described events or circumstances occur generally, typically, or approximately.

[0165] Still further, the term "substantially" in certain embodiments refers to at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%, or about 100% of a stated property, ingredient, composition, or other term used to characterize or otherwise quantify the amount of substantial.

[0166] As used herein, the term "substantially," e.g., in the context of "substantially identical" or "substantially similar," refers to a method, system, or component that is at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%, or about 100% similar to the method, system, or component being compared.

[0167] Although the operations of example embodiments of the disclosed methods may be specifically described in a sequential order for convenience, it should be understood that the disclosed embodiments may encompass orders of operations other than the specific sequential order disclosed. For example, operations described as sequential may, in some cases, be reordered or performed simultaneously. Furthermore, descriptions and disclosures provided in connection with one specific embodiment are not limited to that embodiment and may apply to any disclosed embodiment.

[0168] Moreover, for simplicity, the accompanying figures may not show the various ways in which the disclosed systems, methods, and apparatus can be used in combination with other systems, methods, and apparatus, which would be readily discernible by one of ordinary skill in the art based on this disclosure. The description may also use terms such as "producing" and "providing" to describe the disclosed methods. These terms are high-level abstractions of actual operations that may be performed. The actual operations corresponding to these terms may vary depending on the specific implementation and would be readily discernible by one of ordinary skill in the art based on this disclosure.

[0169] Implantable prosthetic valve Aspects of the technology disclosed herein are directed to implantable prosthetic devices and various components of such devices. More specifically, some aspects relate to implantable prosthetic valves.

[0170] It is understood that many common components of medical devices can be at least partially covered with a material comprising a plurality of fibers or fibrous materials. Examples of medical device components that can be covered with or associated with a fabric or other material comprising fibers include certain stents, which can generally have the form of a conduit configured to be placed in the body to create or maintain a passageway therein or to provide a relatively stable anchoring structure for supporting one or more other devices or biological structures. Stents at least partially covered with fabric can be used for a variety of purposes, such as for the dilation of certain ducts, including blood vessels, glands, or other ducts, whether vasculature, coronary arteries, bile ducts, or other types. In the context of prosthetic heart valve devices, the stent serves as a structural component for anchoring the prosthetic heart valve to the tissue of the heart valve annulus. Such stents can have a variety of shapes and / or diameters.

[0171] It should be understood that prosthetic heart valve implants, and many other types of prosthetic and other types of devices, can include various fabric-covered components and / or portions. For example, a sealing portion of a medical implant device, such as a prosthetic heart valve skirt component / portion, can be secured to the frame of the medical implant device to help prevent blood from leaking around the outer edge or periphery of the device.

[0172] In some implementations, fabric coverings for medical device components may be secured using sutures. For example, in some implementations, a human operator may handle and perform sutures on an implanted device component to secure the fabric to the component. However, performing suturing by a human operator may be relatively difficult and / or cumbersome in certain circumstances. For example, when fine stitching is performed with a relatively high degree of precision, the complexity and / or associated operator load may result in injury / strain and / or undesirably poor product quality. Furthermore, medical implant devices, such as certain heart valve implant devices, may require 1000 or more stitches, which may involve a substantially labor-intensive and error-prone suturing procedure. Therefore, reducing collaborative human involvement in the application of fibrous materials to medical device components may be desirable to improve quality and efficiency and / or reduce operator burden.

[0173] Certain embodiments disclosed herein provide implantable prosthetic devices that may include materials comprising a plurality of fibers comprising electrospun silk. Further disclosed herein are embodiments in which these materials and devices are formed using electrospinning devices, systems, processes, and mechanisms. Examples of medical implant devices and heart valve structures that may be applicable to certain embodiments presented herein are disclosed in U.S. Patent Application Publication No. 2007 / 0129994, the entire contents of which are hereby expressly incorporated by reference for all purposes.

[0174] Embodiments disclosed below include materials comprising a plurality of fibers, at least one of which comprises electrospun silk. Such materials can be formed by an electrospinning process, as disclosed in detail below. The electrospinning process generally employs a high voltage to create an electric field between a droplet of polymer solution at the tip of a needle and a collector plate, as described in detail below. In certain embodiments, one electrode of a voltage source can be placed in the solution, while the other electrode is connected to the collector. This creates an electrostatic force. As the voltage is increased, the electric field increases, causing a force to build up on the pendant droplet of polymer solution at the tip of the needle. This force acts in the opposite direction to the surface tension of the droplet. The increased electrostatic force causes the droplet to expand and form a cone. When the electrostatic force overcomes the surface tension of the droplet, a continuous, electrically charged jet of solution is released from the cone. The jet of solution accelerates toward the collector, whipping violently. As the solution leaves the needle and travels toward the collector, the jet rapidly thins and dries as the solvent evaporates. A nonwoven mat of randomly oriented solid nanofibers is deposited on the surface of the grounded collector. Certain methods, devices, and systems relating to electrospinning concepts that may be applicable to embodiments of the present disclosure are disclosed in U.S. Patent No. 6,273,999, the disclosure of which is hereby incorporated by reference in its entirety. Certain embodiments of the method are also disclosed in more detail below.

[0175] Embodiments disclosed herein relate to materials comprising a plurality of electrospun silk fibers. To electrospin fibers, a natural protein, silk fibroin (SF), is often utilized, as described in detail below. SF derived from silkworms plays an important role in biomedical applications and tissue engineering (Non-Patent Documents 3 and 4). Silkworms are primarily composed of silk fibroin coated with sericin, with a content of over 95%. It is known that small amounts of carbohydrates and other impurities may be present in silkworms. The SF structure is primarily composed of glycine (46%), alanine (29%), serine (18%), and 18 other amino acids (Non-Patent Document 5). SF consists of a light (L) chain polypeptide and a heavy (H) chain polypeptide linked together via a single disulfide bond at the C-terminus of the H chain, forming an HL complex (Non-Patent Document 6). SF is considered to be one of the most promising biological materials for practical use due to its unique properties of excellent biocompatibility (Non-Patent Document 7), excellent control of mechanical properties (Non-Patent Document 8), biodegradability (Non-Patent Documents 9 and 10), hemocompatibility, cytocompatibility, and interaction with cells.

[0176] In the embodiments disclosed herein, silk fibroin has been found to be an excellent alternative to previously disclosed materials and fabrics used in implantable prosthetic devices. The use of silk fibroin as a source of fibrous material has been shown to allow for control of the rate of degradation of formed components, an important feature of functional tissue design. Without wishing to be bound by any theory, it is hypothesized that the use of silk fibroin as a source of electrospun silk successfully matches the rate of scaffold degradation to the rate of tissue growth.

[0177] Aspects disclosed herein include an implantable prosthetic valve comprising: an annular frame having inner and outer surfaces, an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; a leaflet structure positioned within the frame; an inner skirt positioned along the inner surface of the frame; and at least one outer skirt positioned around the outer surface of the frame, wherein at least a portion of one of the leaflet structure, the inner skirt, or the at least one outer skirt comprises a material including a plurality of fibers, and at least one fiber of the plurality of fibers comprises electrospun silk, and the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0178] Also disclosed herein are embodiments of an implantable prosthetic valve comprising: an annular frame having inner and outer surfaces, an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; a leaflet structure positioned within the frame; and at least one outer skirt positioned around the outer surface of the frame, wherein at least a portion of the leaflet structure or one of the at least one outer skirt comprises a material including a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; and wherein the implantable prosthetic valve is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration. In such embodiments, an inner skirt need not be present in the disclosed implantable prosthetic devices. However, disclosed are embodiments in which an inner skirt is also present. It is further understood that all other materials that may be present in the leaflet structure and / or outer skirt may be any of the materials disclosed below.

[0179] Also disclosed herein are embodiments of an implantable prosthetic valve comprising: an annular frame having inner and outer surfaces, an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; a leaflet structure positioned within the frame; and an inner skirt positioned around the inner surface of the frame, wherein at least a portion of one of the leaflet structure or the inner skirt comprises a material including a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; and wherein the implantable prosthetic valve is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration. In such embodiments, an outer skirt need not be present in the disclosed implantable prosthetic devices. However, disclosed are embodiments in which an outer skirt is also present. It is further understood that all other materials that may be present in the leaflet structure and / or inner skirt may be any of the materials disclosed below.

[0180] Also disclosed are embodiments of an implantable prosthetic valve comprising an annular frame having inner and outer surfaces, an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end, wherein at least one of the following components is also present: a leaflet structure positioned within the frame, an inner skirt positioned along the inner surface of the frame, and at least one outer skirt positioned around the outer surface of the frame, wherein, if at least one of the disclosed components is present, at least a portion of these components comprise a material including a plurality of fibers, at least one fiber of the plurality of fibers comprises electrospun silk, and the implantable prosthetic valve is radially collapseable to a collapsed configuration and radially expandable to an expanded configuration. It is understood that in these particular embodiments, the leaflet structure may or may not be present, the inner skirt may or may not be present, or the outer skirt may or may not be present. It is further understood that all other materials that may be present in either the leaflet structure, the inner skirt, and / or the outer skirt may be any of the materials disclosed below.

[0181] In certain disclosed embodiments, an implantable prosthetic device can include an annular frame having an inner and outer surface, the frame having an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end. Figure 1 shows an exemplary frame 110 having a central longitudinal axis 100 extending from the inflow portion 16 to the outflow portion 18 of an example stent that may be used in an implantable prosthetic device according to one or more embodiments of the present disclosure. The frame 110 can be made from laser-cut tubing of a plastically expandable metal or other at least partially rigid material. It is understood that, because an implantable prosthetic valve is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration, the frame 110 can also be at least partially radially collapsed to a collapsed configuration and at least partially radially expandable to an expanded configuration. Although a laser-cut stent is shown, it should be understood that other frames can be used with the devices and methods disclosed herein, including, for example, stents comprising a rigid ring that fits within, for example, the annulus of a heart valve and defines an opening therethrough for the passage of blood, spirally wound tubing, and other tubes / conduits.

[0182] The frame 110 can be at least partially self-expanding and / or mechanically expandable (e.g., balloon-expandable). For example, a self-expanding stent frame can be collapsed or pushed into a small tube and retain sufficient elasticity to spring outward on its own when a constraint such as an outer sheath / catheter is removed. In contrast, a balloon-expandable stent can comprise a relatively less elastic material that is capable of plastically expanding from the inside out when the stent is transformed from a contracted diameter / configuration to an expanded diameter / configuration. The plastic expansion can be accomplished with a balloon or other device, such as a device with mechanical fingers. With such a balloon-expandable stent, the stent frame can plastically deform after application of a deforming force, such as inflating a balloon or expanding mechanical fingers.

[0183] The stent (e.g., a self-expanding stent or a balloon-expandable stent) frame 110 can be used as part of a prosthetic heart valve with a one-stage implantation in which a surgeon secures a heart valve having a fibrous anchoring skirt and a valve member to the heart valve annulus as one unit or component. A particular stent solution for aortic valve replacement according to certain aspects of the present disclosure is disclosed in U.S. Patent No. 6,273,999, which is incorporated herein by reference in its entirety. In one implementation, an exemplary delivery system advances a valve implantation device with a stent at its tip or distal end until the valve implantation device is positioned within the valve annulus and / or left ventricular outflow tract, at which point a balloon can be inflated to expand the stent against the aortic valve annulus and / or ventricular tissue.

[0184] As shown in FIG. 1 , the stent frame 110 is generally annular and / or cylindrical and includes a plurality of diagonally spaced, vertically extending, interlocking, attached posts or struts 118. The posts 118 may be interconnected by at least a circumferentially extending strut 120 in a lower row and circumferentially extending struts 122 and 124 in each of one or more upper rows. The struts in each row may be arranged in a zigzag or generally sawtooth pattern extending toward the periphery of the frame, as shown. Adjacent struts in the same row may be interconnected to each other to form an angle between about 90 and 110 degrees. The angle between adjacent struts may be selected to optimize the radial strength of the frame 110 and allow the frame 110 to collapse and expand uniformly, even when expanded.

[0185] In the illustrated embodiment, adjacent pairs of circumferential struts in the same row are connected to one another by respective generally U-shaped cap structures or portions 126. The cap structures 126 may each include a horizontal portion extending between and connecting adjacent ends of the struts such that a gap is defined between the adjacent ends of the struts and the cap structures connect the adjacent ends at locations offset from the natural intersections of the struts. The cap structures 126 can significantly reduce residual strain in the frame 110 at the locations of the struts 120, 122, and 124 during contraction and expansion of the frame 110. Each pair of struts 122 connected at a common cap structure 126 can generally form a cell with an adjacent pair of struts 124 in that row. Each cell can be connected to an adjacent cell at a node 132. Each intersection 132 is interconnected to the lower row of struts by a respective vertical (axial) strut 130 that is connected to the respective intersection 132 and extends between the respective intersection 132 and the location in the lower row of struts 120 where two struts are connected at opposite ends to the crown structure 126.

[0186] In certain embodiments, the lower struts 120 have a greater thickness or diameter than the upper struts 122, 124. In one implementation, for example, the lower struts 120 have a thickness of approximately 0.42 mm, and the upper struts 122, 124 have a thickness of 0.38 mm. In the particular embodiment of FIG. 1 , there is only one row of lower struts 120 and two rows of upper struts 122, 124, so the expansion of the lower struts 120 relative to the upper struts 122, 124 can advantageously increase the radial strength of the frame 110 in the lower region of the frame and / or allow for more uniform expansion of the frame. Columns of the frame 110 can be defined by adjacent pairs of struts 120, 122, 124 extending between two axially extending struts 130. In some embodiments, the frame 110 comprises three 120-degree sections, each bounded by two posts 118. 1 includes a total of nine columns. In some embodiments, the number of columns and rows may be desirably minimized to reduce the overall reduced profile of frame 110 and / or the associated valve. Again, it is understood that this frame is merely exemplary and that other frames may be used in the disclosed implantable prosthetic devices and methods of making the same.

[0187] In still further aspects, an implantable device as disclosed herein comprises a leaflet structure positioned on a frame, and / or an inner skirt positioned along the inner surface of the frame, and / or at least one outer skirt positioned around the outer surface of the frame. As disclosed herein, at least a portion of one of the leaflet structure, the inner skirt, or the at least one outer skirt comprises a material comprising a plurality of fibers, and at least one fiber of the plurality of fibers comprises electrospun silk. However, it is further understood that in certain aspects, any or all of the disclosed components may comprise a material comprising a plurality of electrospun silk fibers.

[0188] In certain embodiments, when at least a portion or the entire surface of the inner skirt comprises a material comprising a plurality of fibers including electrospun silk, the material is referred to as a first material. While in other embodiments, when at least a portion or the entire surface of the outer skirt comprises a material comprising a plurality of fibers including electrospun silk, the material is referred to as a second material. While in still further embodiments, when at least a portion or the entire surface of the leaflet structure comprises a material comprising a plurality of fibers including electrospun silk, the material is referred to as a third material. It is understood that these definitions are used to distinguish between the materials of each component and do not dictate a particular order or specific materials. It is understood that the first material, second material, and / or third material can be the same or different, as described below.

[0189] It is further understood that, as described below, each or all of the materials, including electrospun silk, can be designed to have specific properties depending on the desired application. For example, the fibrous material used to form the valve leaflet structure (the third material as disclosed herein) can be designed to exhibit different properties than those required for the material used for the inner skirt (the first material) or the outer skirt (the second material) of the implantable device. Thus, described herein are embodiments in which the first, second, and third materials are the same, as well as embodiments in which the first, second, and third materials are different.

[0190] Exemplary, non-limiting implantable prosthetic devices having various components are shown in FIGS. 3A-3B. For example, FIG. 3A shows a device 300 having a frame 310 similar to the frame 110 described in FIG. 1. When assembled, the valve 300 in the illustrated embodiment comprises a leaflet structure 364 supported by the stent frame 310, which in turn comprises an inner skirt 301 applied to the stent frame 310. In this illustrated embodiment, either or both of the leaflet structure 364 and the inner skirt 301 can comprise a material comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk. In such an embodiment, for example, the leaflet structure can comprise a third material as disclosed herein, while the inner skirt can comprise a first material, also as disclosed herein. However, it is understood that also disclosed herein are embodiments in which, for example, only the inner skirt comprises a first material and the leaflet structure does not comprise a third material as described. In such exemplary, non-limiting embodiments, the leaflet structure may include any other material commonly used for the desired application. In still further exemplary embodiments, only the leaflet structure includes the third material disclosed herein, and the inner structure does not include the first material as disclosed. In such exemplary, non-limiting embodiments, the inner skirt may include any other material commonly used for the desired application. In still further embodiments, these materials may exhibit any of the properties disclosed herein.

[0191] In still further embodiments, as discussed in detail below, the leaflet structure 364 can be formed by electrospinning methods. In certain embodiments, the third material comprising the leaflet structure can be formed by electrospinning silk fibroin fibers, for example, on a third predetermined mandrel. In such embodiments, the third predetermined mandrel can have the shape of the desired leaflet structure (e.g., FIG. 7A), or can be cut to the desired shape from a sheet of the third material prepared by electrospinning (e.g., FIG. 7B).

[0192] Similarly, inner skirt 301 may be formed by direct electrospinning, as discussed in detail below, or may be prepared from a sheet of first material, cut to the desired shape, and then attached to the frame by any known technical method. For example, inner skirt 301 may be attached to the inner surface of the frame by fasteners. In certain embodiments, the fasteners may comprise adhesive and / or sutures.

[0193] Valve implantation device 300 may be suitable for implantation in the annulus of a native aortic valve, but may also be adapted to be implanted in the annulus of a native valve of the heart or various other ducts or orifices of the body, for example. Valve implantation device 300 has an inflow end 380 and an outflow end 382.

[0194] The valve implantation device 300 and stent frame 310 as disclosed herein are configured to be radially collapsed to a collapsed or reduced state for introduction into the body within a delivery catheter and to be radially expandable to an expanded state for implanting the valve 300 at a desired location in the body (e.g., the native aortic valve). For example, without limitation, the stent frame 310 can be made from a plastically expandable material that allows for reduction of the valve to a smaller profile for delivery and expansion of the valve using an expansion device, such as a balloon on a balloon catheter. Alternatively, the valve implantation device 300 can be a self-expanding valve, and the frame can be made from a self-expanding material, such as a shape-memory alloy (e.g., nitinol). A self-expanding valve can be reduced to a smaller profile and retained in the reduced state with a retention device, such as a sheath, that covers the valve. When the valve is positioned at or near the target site, the retention device can be removed to allow the valve to self-expand to its expanded, functional size. However, it will be further understood that other materials suitable for this purpose can be used to form the frame.

[0195] Other exemplary embodiments of implantable medical devices are shown in FIGS. 3B and 3C. For example, without limitation, FIG. 3B illustrates an exemplary embodiment of a radially collapsible and expandable prosthetic valve 10 shown in its deployed, expanded configuration. The prosthetic valve may include an annular stent or frame 1200 and a leaflet structure 140 positioned within and coupled to the frame 1200. The frame 1200 may have an inflow end portion 16 and an outflow end portion 18. The leaflet structure may include multiple leaflets 22. In certain embodiments, the leaflet structure may include three leaflets. In such exemplary embodiments, such three leaflets may be arranged to collapse in a tricuspid arrangement similar to the aortic valve. Alternatively, the prosthetic valve may include two leaflets 22 configured to collapse in a bicuspid arrangement similar to the mitral valve, or four or more leaflets, depending on the particular application. It is understood that disclosed herein are embodiments in which the leaflet structure 140 includes a third material as disclosed herein. However, also disclosed herein are embodiments in which the leaflet structure does not include a third material as disclosed herein. In such exemplary embodiments, the leaflet structure may include any material known in the art. The prosthetic valve 10 may define a longitudinal axis 24 extending through the inflow end portion 16 and the outflow end portion 18.

[0196] The frame 1200 may be made from any of a variety of biocompatible materials, such as stainless steel or a nickel-titanium alloy ("NiTi"), e.g., Nitinol. Referring to FIG. 3B, the frame 1200 may include a plurality of interconnected lattice struts 26 arranged in a lattice-style pattern, forming a plurality of apices 28 at the outflow end 18 of the prosthetic valve. The struts 26 may also form similar apices (covered by an outer skirt 30, described in more detail below) at the inflow end 16 of the prosthetic valve. The lattice struts 26 are shown positioned obliquely or at an angle to the longitudinal axis 24 of the prosthetic valve, and radially offset from the longitudinal axis 24. It is understood that the configuration depicted in FIG. 3A is merely exemplary, and that in other embodiments, the lattice struts 26 may be offset by an amount different from that depicted in FIG. 3A, or some or all of the lattice struts 26 may be positioned parallel to the longitudinal axis 24 of the prosthetic valve.

[0197] The lattice struts 26 may be pivotally coupled relative to one another. In the illustrated embodiment, for example, end portions of the struts 26 forming the apexes 28 at the outflow and inflow ends 18, 16 of the frame may have respective openings 32. The struts 26 may also have openings 34 formed therein positioned between opposite ends of the struts. Respective hinges may be formed at the apexes 28 and where the struts 26 overlap each other between the ends of the frame via fasteners 36, which may comprise rivets or pins extending through the openings 32, 34. The hinges may allow the struts 26 to pivot relative to one another when the frame 1200 is expanded or contracted, such as during assembly, preparation, or implantation of the prosthetic valve 10. For example, the frame 1200 (and thus the prosthetic valve 10) may be manipulated into a radially compressed or contracted configuration, coupled to a delivery device, and inserted into a subject for implantation. Once inside the body, the prosthetic valve 10 can be manipulated to an expanded state and then released from the delivery device. Additional details regarding the frame 1200, the delivery device, and devices and techniques for radially expanding and collapsing the frame can be found in U.S. Patent No. 6,273,999, which is incorporated herein by reference. Additional details regarding such an exemplary prosthetic valve can also be found in U.S. Patent No. 6,273,999, which is incorporated herein by reference.

[0198] As further shown in FIG. 3A , the prosthetic valve 10 may include a sealing element configured as an outer skirt 30. The outer skirt 30 as shown herein may comprise a second material as disclosed herein, while in other embodiments, the outer skirt 30 may comprise any other material known in the art that can be adapted for a desired application. In such embodiments, another skirt (not shown), known as an inner skirt, may be attached to the frame below the outer skirt 30. In embodiments where an inner skirt is also present, the inner skirt may comprise a first material as disclosed herein, while in other embodiments, when an inner skirt is present, the inner skirt may comprise any other material known in the art and applicable to a desired application.

[0199] The outer skirt 30 may be configured to establish a seal with native tissue at the treatment site to reduce or prevent paravalvular leakage. The outer skirt 30 may include a main body portion 38 disposed around the outer periphery of the frame 1200. The outer skirt 30 may be secured to the frame by direct electrospinning, as discussed in detail below and shown, for example, in FIG. 2, or may be formed by a separate electrospinning process and attached to the frame with fasteners. In such exemplary embodiments, if the outer skirt 30 is formed by indirect electrospinning, the desired skirt configuration may be cut to the desired shape and dimensions and attached to the frame. Any fastener or attachment technique known in the art may be used for this purpose. For example, the fastener or attachment technique may be attached with an adhesive, with sutures, or by ultrasonic welding. Further details regarding transcatheter prosthetic heart valves, including the manner in which the valve leaflets 22 may be attached to the frame 1200, may be found, for example, in U.S. Patent Nos. 5,629,997 and 5,729,973, ...

[0200] FIG. 3C shows a prosthetic valve 10 including another embodiment of a sealing member or outer skirt 320. In the illustrated and non-limiting embodiment, the skirt 320 includes a second material configured as a woven piece 322 having an edge portion 328, as described herein. Such an outer skirt 320 can be formed by direct electrospinning, as discussed below, or can be cut to the desired shape from a third material prepared as a sheet. In certain exemplary embodiments, the skirt 320 can be secured to the struts 26 to form a skirt layer (not shown). Strut securing can again be achieved by direct electrospinning of silk fibers or by attaching a separately prepared skirt material with adhesive or fasteners such as various sutures. It is further understood that any configuration of the skirt that couples with the frame can be used depending on the desired application. It is understood that the implantable prosthetic devices disclosed above are merely exemplary, and that other devices can be formed. Certain additional examples of other prosthetic spacer devices are further described in US Pat. Nos. 5,629,299, 5,729,317, 5,729,327, and 5,729,337, which are incorporated herein by reference.

[0201] Also disclosed herein are embodiments in which each fiber of the plurality of fibers present in the first material, the second material, and / or the third material has a first extension direction and a plurality of undulations. In still further embodiments, the first extension direction can include a circumferential direction, a radial direction, or a combination thereof, while in other embodiments, the plurality of undulations are present in the collapsed configuration. In still further embodiments, the plurality of undulations are configured to straighten when the implantable prosthetic valve is in the expanded configuration. Such an exemplary embodiment is shown in FIG. 2, which illustrates exemplary devices 200 (in the expanded configuration) and 200a (in the collapsed configuration). In this exemplary embodiment, an exemplary outer skirt 204 is formed by electrospinning directly on a frame 202. An exemplary undulation 206 can be observed in FIG. 2. It is understood that these undulations can be formed by any method known in the art. In certain non-limiting embodiments, undulations can be formed by electrospinning the second material in a fully expanded frame 202 and then collapsing the frame to a collapsed position. In still further embodiments, undulations can be formed, for example, without limitation, by introducing some stretching means during electrospinning and removing this means when electrospinning of the desired material is complete.

[0202] As previously disclosed, in certain embodiments, an adhesive material may be disposed between at least a portion of the annular frame and at least a portion of the outer skirt and / or at least a portion of the inner skirt to improve adhesion between the frame and components electrospun or attached to the frame. As in any of the previously disclosed embodiments, at least a portion of the inner skirt may be attached to the annular frame by directly electrospinning a plurality of fibers onto at least a portion of the inner surface of the annular frame. While in other embodiments, the inner skirt material may be formed by electrospinning from a silk fibroin solution to form a sheet of material comprising electrospun silk, from which the inner skirt may be cut (e.g., laser cutting or ultrasonic cutting) by any art-known method and attached to the frame. Similarly, in some embodiments, at least a portion of the outer skirt may be attached to at least a portion of the annular frame by directly electrospinning a plurality of fibers onto at least a portion of the outer surface of the annular frame. While in other embodiments, the outer skirt material can also be formed by electrospinning from a silk fibroin solution to form a sheet of electrospun silk-containing material, from which the outer skirt can be cut by any art-known method (e.g., laser cutting or ultrasonic cutting) and attached to the frame.

[0203] In still further embodiments, at least a portion of the plurality of fibers have a random orientation, while in other embodiments, at least a portion of the plurality of fibers have a predetermined side-by-side orientation. In still further embodiments, the first material, the second material, and / or the third material can include at least a portion of the plurality of fibers having a random orientation and at least a portion of the plurality of fibers having a predetermined side-by-side orientation. In such exemplary embodiments, the orientation or lack of orientation of the fibers can be controlled by various parameters of the electrospinning process, as disclosed below.

[0204] In certain embodiments, additional fibers may be present in the first material, and / or the second material, and / or the third material to control and / or modify the mechanical properties of these materials. For example, the plurality of fibers may be: Absorbency material, Non-absorbable materials, or combinations thereof. For example, in certain embodiments, to achieve desired mechanical properties, the plurality of fibers may further comprise thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefins such as polypropylene, polyether ether ketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. In certain embodiments, when only biodegradable and biocompatible fibers are desired, the plurality of fibers may comprise polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. In embodiments where it is not desired that the final component be bioabsorbable, other fibers may be present, such as thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymers, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefins such as polypropylene, polyetheretherketone (PEEK), or combinations thereof. It is understood that any known variant of PET may be used, including, without limitation, high tenacity PET.

[0205] In certain exemplary, non-limiting embodiments, at least a portion of the plurality of fibers may comprise bicomponent fibers, depending on the desired application. It is understood that any art-known configuration of bicomponent fibers may be utilized. For example, without limitation, the bicomponent fibers may comprise a side-by-side configuration, a sheath-core configuration, an islands-in-the-sea configuration, a trilobal configuration, a split-pie configuration, or any combination thereof. In still further exemplary embodiments, the bicomponent fibers comprise a sheath-core configuration. In some embodiments, the sheath and / or core may comprise: Absorbency material, Non-absorbableIn certain embodiments, the sheath of the bicomponent fiber may comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. and the bi-fiber core can comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyether ether ketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. In yet further exemplary embodiments, the sheath of the bicomponent fiber can comprise silk, while the core of the bicomponent fiber can comprise one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(esterurethane)urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0206] In still further embodiments, the plurality of fibers have a diameter of about 5 nm, about 10 nm, about 15 nm, about 20 nm, about 25 nm, about 30 nm, about 35 nm, about 40 nm, about 45 nm, about 50 nm, about 55 nm, about 60 nm, about 65 nm, about 70 nm, about 75 nm, about 80 nm, about 85 nm, about 90 nm, about 95 nm, about 100 nm, about 150 nm, about 200 nm, about 300 nm, about 400 nm, about 500 nm, about 600 nm, about 700 nm, about 800 nm, about 900 nm, about 1,000 nm, about 1,200 nm, about 1,500 nm, about 2,000 nm, about 2,500 nm, about 3,000 nm, about 3,500 nm , about 4,000 nm, about 4,500 nm, about 5,000 nm, about 5,500 nm, about 6,000 nm, about 6,500 nm, about 7,000 nm, about 7,500 nm, about 8,000 nm, about 8,500 nm, about 9,000 nm, about 9,500 nm, about 10,000 nm, about 10,500 nm, about 11,000 nm, about 11,500 nm, about 12,000 nm, about 12,500 nm, about 12,000 nm, about 12,500 nm, about 13,000 nm, about 13,500 nm, about 14,000 nm, and about 13,400 nm. It is understood that the fibers can have an average diameter between any two of the above values, and it is further understood that the average diameter of the fibers can be controlled by the electrospinning parameters, as discussed in detail below.

[0207] In still further embodiments, the first material, second material, and / or third material can have a thickness of about 0.1 μm to about 2 mm, including exemplary values ​​of about 0.2 μm, about 0.5 μm, about 1 μm, 5 μm, about 10 μm, about 15 μm, about 20 μm, about 30 μm, about 50 μm, about 100 μm, about 200 μm, about 300 μm, about 400 μm, about 500 μm, about 600 μm, about 700 μm, about 800 μm, about 900 μm, about 1 mm, about 1.2 mm, about 1.3 mm, about 1.4 mm, about 1.5 μm, about 1.6 mm, about 1.7 mm, and about 1.9 mm. Still further, the thickness can be any thickness between any two of the above values. Again, it is further understood that the thickness of the material can be controlled by varying the parameters of the electrospinning process.

[0208] In yet further embodiments, at least a portion of the first material, and / or the second material, and / or the third material exhibits porosity. As referred to herein, it is understood that the term "pore size" refers to the average size of the pores in the nanofiber. As used herein, porosity is defined by the ratio of pores to a unit of volume. Again, it is understood that the level of porosity and / or pore size can be controlled by varying the parameters of the electrospinning process. In exemplary embodiments disclosed herein, at least a portion of the first material, and / or the second material, and / or the third material may be about 150 nm, about 200 nm, about 300 nm, about 400 nm, about 500 nm, about 600 nm, about 700 nm, about 800 nm, about 900 nm, about 1,000 nm, about 1,200 nm, about 1,500 nm, about 2,000 nm, about 2,500 nm, about 3,000 nm, about 3,500 nm, about 4,000 nm, about 4,500 nm, about 5,000 nm, about 5,500 nm, or about 6,000 nm. The porosity may have an average pore size of about 100 nm to about 100 μm, including exemplary values ​​of about 6,000 nm, about 6,500 nm, about 7,000 nm, about 7,500 nm, about 8,000 nm, about 8,500 nm, about 9,000 nm, about 9,500 nm, about 1 μm, about 1.5 μm, about 2 μm, about 2.5 μm, about 3 μm, about 3.5 μm, about 4 μm, about 4.5 μm, about 5 μm, about 10 μm, about 15 μm, about 20 μm, about 30 μm, about 40 μm, about 50 μm, about 60 μm, about 70 μm, about 80 μm, and about 90 μm. Still further, the porosity may have any value between any two of the above values.

[0209] Exemplary materials with various average fiber diameters and porosities are shown in Figure 4. In these exemplary embodiments, it can be seen that the fiber diameter and porosity can be controlled with the concentration of the active agent in the electrospinning solution.

[0210] Also disclosed herein are embodiments in which the first material, second material, and / or third material comprise multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers is disposed one on top of the other. It is understood that the number of layers can be any number that provides the desired material. In such exemplary embodiments, at least a first portion of the multiple layers can have a surface area that is substantially smaller than the surface area of ​​a second portion of the multiple layers. It is understood that such different portions of the layers can be formed by varying electrospinning parameters during the electrospinning process. Electrospinning parameters can include the distance between the spinneret and the collecting substrate, the magnitude of the applied voltage used during electrospinning, the extrusion speed, and the spin speed of the collecting substrate, if rotating. For example, some portions of the material can be more porous and therefore have a larger surface area than other portions of the material. In certain exemplary, non-limiting embodiments, when substantial tissue growth is not desired, some portions of the layers can be constructed to be very dense and have little porosity, providing a substantially smoother surface. While in other embodiments, if extensive tissue growth is desired, portions of the layer can have greater porosity and less density, again, it is understood that the pore size, and therefore the surface area, can be controlled by varying various electrospinning process parameters.

[0211] Also, as previously disclosed, various components of the implantable device may have different desired properties. For example, the inner skirt or leaflet structure of the device may not need to undergo excessive growth or need to be rapidly bioabsorbed. In such embodiments, a denser, less porous material may be utilized. Also, in such embodiments, any of the additional fibers previously disclosed may be present in the plurality of fibers to increase the mechanical strength of the material and regulate bioabsorption and / or biodegradability as desired.

[0212] Disclosed herein are embodiments in which the first material, and / or second material, and / or third material may comprise various layers comprising various multiple fibers. For example, without limitation, in certain embodiments, any of the disclosed materials may have multiple layers with different fiber compositions. In one exemplary, non-limiting embodiment, the material may have multiple layers comprising electrospun silk, followed by multiple layers comprising electrospun silk and any of the previously disclosed polymers, followed by multiple layers comprising any of the previously disclosed polymers without the presence of electrospun silk, and so on. Again, it is understood that the listed order of the multiple layers is merely exemplary, and that any or none of the disclosed layers may be present.

[0213] For example, at least a portion of the inner skirt can include a first porous material having a first surface facing the annular frame and an opposite second surface, and the first material including a plurality of fibers including electrospun silk is disposed on the first and / or second surface of the first porous material. In yet another example, at least a portion of the outer skirt can further include a second porous material having a first surface facing the annular frame and an opposite second surface, and the second material including a plurality of fibers including electrospun silk is disposed on the first and / or second surface of the second porous material. In yet another example, at least a portion of the leaflet structure can include a third porous material having a first surface facing the annular frame and an opposite second surface, and the third material including a plurality of fibers including electrospun silk is disposed on the first and / or second surface of the third porous material.

[0214] Also disclosed are examples in which at least a portion of a first surface of the first material includes a first auxiliary layer and / or at least a portion of a second surface of the first material includes a first auxiliary layer. In such exemplary embodiments, the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0215] Also disclosed are examples in which at least a portion of the first surface of the second material includes a second auxiliary layer and / or at least a portion of the second surface of the second material includes a second auxiliary layer, In such exemplary embodiments, the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0216] Also disclosed are examples in which at least a portion of a first surface of the third material includes a third auxiliary layer and / or at least a portion of a second surface of the third material includes a third auxiliary layer, and in such exemplary non-limiting embodiments, the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0217] In still further embodiments, as shown in Figures 12A-13C, the first material, second material, and / or third material can have various configurations. For example, without limitation, each or any of these materials can include at least one perforated material A (Figure 12A) and at least one layer of electrospun fiber B (Figure 12B) as disclosed herein. While in other embodiments, each or any of these materials can include at least one layer of electrospun fiber B as disclosed herein and at least one layer of auxiliary layer C (Figure 12C). While in yet other embodiments, each or any of these materials can include at least one perforated material A, at least one layer of electrospun fiber B as disclosed herein and at least one layer of auxiliary layer C.

[0218] Certain exemplary, non-limiting configurations are further illustrated in Figures 13A-13C. For example, Figure 13A illustrates a material configuration 1300 in which an inner surface of at least one layer of the electrospun fibers 1304 disclosed herein is covered or coated with at least one auxiliary layer 1302, while a perforated material 1306 is disposed on the outer surface of at least one layer of the electrospun fibers 1304 disclosed herein. It is understood that embodiments in which an auxiliary layer is disposed on the inner surface of the electrospun fiber and a perforated material is disposed on the outer surface of the electrospun fiber are also disclosed herein.

[0219] In still further embodiments, additional configurations may be considered. For example, as shown in Figure 13B, at least one layer of any of the electrospun fibers disclosed herein may be sandwiched between at least two perforated materials 1306a and 1306b. It is understood that these two perforated materials may be the same or different and may comprise any of the materials disclosed below.

[0220] In still further embodiments, the material configuration may lack perforated material but include at least one auxiliary layer, as shown in Figure 13C. In such embodiments, any of the auxiliary layers listed below may be utilized.

[0221] In some embodiments, any of the perforated materials can include a porous fabric or membrane, the porous fabric or membrane comprising: Absorbency Materials, or Non-absorbableThe porous material may comprise one or more biocompatible polymers, including polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymers, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-co-glycolic acid (PLGA), or a combination thereof, or the natural / regenerated fibers may be selected from cotton, silk, hemp, cellulose acetate, collagen, or a combination thereof. It is understood that the degree of porosity can be adjusted depending on the desired performance of the final material.

[0222] In still other embodiments, any of the auxiliary layers may comprise one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA). Absorbency material, Non-absorbable It is understood that the present invention may include any of a variety of materials, including, but not limited to, any of a number of different materials, or any combination thereof.

[0223] It is understood that in some embodiments, the first material may comprise the electrospun fibers disclosed herein and at least one perforated material and / or at least one auxiliary layer. In yet further embodiments, the second material may comprise the electrospun fibers disclosed herein and at least one perforated material and / or at least one auxiliary layer, while in still further embodiments, the third material may comprise the electrospun fibers disclosed herein and at least one perforated material and / or at least one auxiliary layer. It is also understood that in some embodiments, some of the materials include all layers, while in other embodiments, some of the materials include only some of the layers. It is also understood that all combinations of layers can be found in any or all of the first, second, and third materials.

[0224] In still further aspects, the presence of a porous material can provide enhanced mechanical properties of the nanofibers while still benefiting from the nanofiber structure exposing these fibers through the porous structure.

[0225] In other aspects, any of the auxiliary layers disclosed herein are configured to impart hydrophobic or hydrophilic properties, elasticity, mechanical recovery, adhesive properties, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first, second, and / or third material. For example, when TPU or PU is used as an auxiliary layer on at least a portion of the inner and / or outer surfaces of a plurality of electrospun fibers, it is understood that this portion will have increased mechanical properties while inhibiting tissue ingrowth.

[0226] In certain embodiments, the first material, and / or the second material, and / or the third material may be at a pressure of about 0.5 MPa, about 1 MPa, about 1.5 MPa, about 2 MPa, about 2.5 MPa, about 3 MPa, about 3.5 MPa, about 4 MPa, about 4.5 MPa, about 5 MPa, about 5.5 MPa, about 6 MPa, about 6.5 MPa, about 7.0 MPa, about 7.5 MPa, about 8 MPa, about 8.5 MPa, about 9.5 MPa, about 10 MPa, about 11. The first material, second material, and / or third material may exhibit a tensile strength of greater than 0 MPa to about 20 MPa, including exemplary values ​​of 5 MPa, about 11 MPa, about 11.5 MPa, about 12 MPa, about 12.5 MPa, about 13 MPa, about 13.5 MPa, about 14 MPa, about 14.5 MPa, about 15 MPa, about 15.5 MPa, about 16 MPa, about 16.5 MPa, about 17.0 MPa, about 17.5 MPa, about 18 MPa, about 18.5 MPa, and about 19.5 MPa. Still further, the first material, second material, and / or third material may exhibit a tensile strength that may have any value between any two of the above values.

[0227] In certain embodiments, the first material, second material, and / or third material can exhibit an elongation at break of greater than 0% to about 600%, including exemplary values ​​of about 1%, about 10%, about 50%, about 100%, about 200%, about 300%, about 400%, and about 500%. Furthermore, the first material, second material, and / or third material can exhibit an elongation at break that can have any value between any two of the above values. Again, it is understood that with respect to both the tensile strength and elongation at break parameters, a skilled practitioner will select materials with desired properties for a particular application. For example, the first material used for the inner skirt can have different properties than the third material used to form the leaflet structure. It is further understood that such properties can be adjusted by varying electrospinning parameters, average fiber diameter, porosity, fiber composition, etc.

[0228] In certain embodiments, the first material, second material, and / or third material can exhibit a water contact angle of about 0° to about 180°, including exemplary values ​​of about 10°, about 20°, about 30°, about 40°, about 50°, about 60°, about 70°, about 80°, about 90°, about 100°, about 110°, about 120°, about 130°, about 140°, about 150°, about 160°, and about 170°. It is understood that the first material, second material, and / or third material can exhibit any of the above disclosed water contact angles. It is further understood that materials with small contact angles are considered hydrophilic and materials with large contact angles are considered hydrophobic. The hydrophilicity / hydrophobicity of the first, second, and / or third materials can again be adjusted by altering the density of the formed material and by chemical / physical treatment of the material to impart desired properties to the material. For example, hydrophobicity can be imparted to at least a portion of the fiber by exposing it to a plasma. In one such exemplary embodiment, exposure to a 98% helium + 2% CF4 plasma or a 99% helium + 1% CF4 gas plasma treatment can introduce hydrophobic groups, such as fluorine groups, to the fiber surface to modify the fiber surface properties. In yet another exemplary embodiment, hydrophilicity is imparted by treating the material with an atmospheric pressure plasma of 98% helium + 2% oxygen. In one such exemplary, non-limiting embodiment, oxygen free radicals can be formed. The oxygen free radicals can attach themselves to the fiber in -CO-, -COOH, -COO-, -C=O, and -O-COO groups, increasing the hydrophilicity of nonpolar compounds. In yet a further exemplary embodiment, CH gas can cause plasma polymerization of CH polymers capped with CH end groups, altering the hydrophilicity of the fibers. It is understood that the plasma treatments as shown herein are merely exemplary, and that both atmospheric and vacuum-based plasma treatments can be used. In yet a further embodiment, chemical treatments can also be utilized.In such exemplary embodiments, the first material, and / or the second material, and / or the third material may be treated with various chemical compounds to impart a desired hydrophilic or hydrophobic property, although it will be understood that such treatment must be compatible with the desired application.

[0229] In still further aspects, different portions of the same material may have different properties. For example, without limitation, a material may be designed to have a change in various properties along the dimensions of the material. A material may be designed to have different properties at the surface of the material and in the bulk of the material. Such changes in properties may be gradual or abrupt, depending on the final application of the material. It is understood that properties such as fiber density, average fiber diameter, pore size, and pore density can be varied by adjusting various processing parameters of electrospinning.

[0230] In still further aspects, by adjusting the composition of a plurality of fibers according to aspects disclosed herein, the material can be designed to be bioabsorbable or biodegradable or simply degradable as desired.

[0231] In a still further aspect, the frame itself can be plasma treated to improve the adhesion of the electrospun fibers disposed thereon.

[0232] Still further, as previously disclosed, the first material, and / or the second material, and / or the third material may be at least partially biodegradable. In other embodiments, the first material, and / or the second material, and / or the third material are at least partially bioabsorbable. While in still further embodiments, depending on the fiber composition, the first material, and / or the second material, and / or the third material may be at least partially degradable. Also disclosed herein are embodiments in which the first material, and / or the second material, and / or the third material are scaffold materials.

[0233] Also disclosed herein is an article comprising a material comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk, the article having a collapsed configuration and an expanded configuration, and the article is part of an implantable device. In certain aspects, the article can be a perivalvular leak sealing article.

[0234] Paravalvular leak (PVL) is a complication associated with the implantation of prosthetic heart valves. PVL refers to blood flowing through a passageway between the implanted valve structure and the heart tissue as a result of a lack of proper sealing. PVL is mostly crescent, oval, or rounded in shape, and the course of PVL can be parallel, perpendicular, or tortuous. Transcatheter heart valve (THV) procedures generally use either substantially inelastic woven fabrics or stretchable knitted fabrics for PVL sealing.

[0235] For PVL sealing, woven materials have the advantage of providing better dimensional stability compared to knitted materials, which is beneficial in procedures involving joining valve components together with sutures and laser cutting of components. Furthermore, the pore size and density in woven materials can be designed to balance sealing and tissue ingrowth. On the other hand, knitted materials offer better stretchability than woven fabric structures. Stretchability helps reduce stress on tissues to which medical devices comprising fibrous materials are attached.

[0236] For next-generation THV frame designs with varying frame dimensions, one of the requirements is to adapt the PVL sealing material and / or inner frame material to the changing frame dimensions. Therefore, there is a need for materials with controlled elongation and a smaller profile to provide improved conformance by reducing potential stresses where the fabric is secured to the body lumen. This disclosure describes embodiments utilizing electrospun silk fibers that address the previously disclosed problems. As previously described, the porosity, elongation, and physical strength of the fibers can be controlled during a single manufacturing process by varying the electrospinning parameters.

[0237] The perivalvular leak sealing article as disclosed herein can include any of the previously disclosed inner skirts including a first material comprising a plurality of fibers including electrospun silk. In such embodiments, the inner skirt is configured to be positioned on at least a portion of the inner surface of the annular frame of an implantable prosthetic device. The perivalvular leak sealing article as disclosed herein can also include any of the previously disclosed outer skirts including a second material comprising a plurality of fibers including electrospun silk. In such exemplary embodiments, the outer skirt is configured to be positioned on at least a portion of the outer surface of the annular frame of an implantable prosthetic device.

[0238] The article can also include any of the leaflet structures disclosed herein that include a third material that includes a plurality of fibers that include electrospun silk. In such embodiments, the leaflet structure is configured to be positioned within at least a portion of an annular frame of an implantable prosthetic device. In still further embodiments, the material can include any of the first, second, or third materials disclosed herein, or any combination thereof.

[0239] method The present disclosure also provides methods of forming an implantable prosthetic valve. In such aspects, the method may include: a) providing an annular frame having an inner surface and an outer surface, the frame having an inflow end, an outflow end, and a central longitudinal axis extending from the inflow end to the outflow end; b) forming an inner skirt comprising a first material having a first surface and an opposite second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; c) forming an outer skirt comprising a second material having a first surface and an opposite second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; and d) attaching the inner skirt to at least a portion of the inner surface of the annular frame and the outer skirt to at least a portion of the outer surface of the annular frame, wherein the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0240] In certain embodiments, the steps of forming the inner skirt and attaching the inner skirt are performed simultaneously, while in other embodiments, the step of forming the inner skirt is performed before the attaching step. In still further embodiments, the steps of forming the outer skirt and attaching the outer skirt are performed simultaneously, while in still further embodiments, the step of forming the outer skirt is performed before the attaching step. In certain embodiments, the step of forming the inner skirt is performed before or after the step of forming the outer skirt. Similarly, the methods described herein may further include the step of positioning a leaflet structure comprising a third material having a first surface and an opposing second surface, and comprising a plurality of fibers, wherein at least one fiber of the plurality of fibers comprises electrospun silk within at least a portion of the annular frame. However, it will also be understood that the step of positioning the leaflet structure may be performed before or after the step of forming the inner skirt and / or the outer skirt.

[0241] Embodiments disclosed herein describe electrospinning methods to form a first material, and / or a second material, and / or a third material.

[0242] In embodiments disclosed herein, attaching at least a portion of a first material to at least a portion of the inner surface of the annular frame comprises directly electrospinning at least a portion of a plurality of fibers through at least one spinneret at a predetermined extrusion rate from a first solution comprising silk fibroin at a first predetermined concentration, while in other embodiments, attaching at least a portion of a second material to at least a portion of the outer surface of the annular frame comprises directly electrospinning at least a portion of a plurality of fibers through at least one spinneret at a predetermined extrusion rate from a second solution comprising silk fibroin at a second predetermined concentration.

[0243] Also disclosed are embodiments in which the first and / or second materials are not formed directly onto the annular frame, but are formed separately and then shaped to the desired dimensions and attached to the frame with fasteners.

[0244] For example, forming the first material may include electrospinning at least a portion of the plurality of fibers through at least one spinneret at a first predetermined mandrel at a predetermined extrusion rate from a first solution including a first predetermined concentration of silk fibroin. Thus, in such an exemplary embodiment, attaching includes i) shaping the first material to predetermined dimensions, and ii) attaching the first material to at least a portion of the inner surface of the annular frame.

[0245] Also disclosed are embodiments in which forming the second material includes electrospinning at least a portion of the plurality of fibers through at least one spinneret at a predetermined extrusion rate on a second predetermined mandrel from a second solution comprising silk fibroin at a second predetermined concentration. Thus, in such exemplary embodiments, the attaching includes i) shaping the second material to predetermined dimensions and ii) attaching the second material to at least a portion of the outer surface of the annular frame.

[0246] Still further, the third material is formed by electrospinning a plurality of fibers from a third solution containing silk fibroin at a third predetermined concentration at a predetermined extrusion rate on a third predetermined mandrel, so that the third material can be laser cut into a predetermined shape.

[0247] In certain embodiments, any of the predetermined concentrations of silk fibroin in the first solution, the second solution, or the third solution can be greater than 0% and less than 50% by weight, including exemplary values ​​of about 0.1 wt%, about 0.2 wt%, about 0.3 wt%, about 0.5 wt%, about 0.6 wt%, about 0.7 wt%, about 0.8 wt%, about 0.9 wt%, about 1 wt%, about 2 wt%, about 3 wt%, about 4 wt%, about 5 wt%, about 6 wt%, about 7 wt%, about 8 wt%, about 9 wt%, about 10 wt%, about 15 wt%, about 20 wt%, about 25 wt%, about 30 wt%, about 35 wt%, about 40 wt%, and about 45 wt%. It is understood that the particular concentration can be selected based on the desired application, and in certain embodiments, the concentrations of silk fibroin in the first solution, the second solution, and / or the third solution can be the same or different.

[0248] In still further embodiments, any of the predetermined extrusion rates is about 0.8 μl / hr, about 1 μl / hr, about 2 μl / hr, about 5 μl / hr, about 10 μl / hr, about 20 μl / hr, about 50 μl / hr, about 100 μl / hr, about 250 μl / hr, about 500 μl / hr, about 1 ml / hr, about 10 ml / hr, about 50 ml / hr, about 100 ml / hr, about 250 ml / hr, about 500 ml / hr, about 750 ml / hr, about 1 ml / hr, about 10 ml / hr, about 50 ml / hr, about 100 The extrusion rate can be anywhere between 0.7 μl / hr and about 10,000 ml / hr, including exemplary values ​​of about 250 ml / hr, about 500 ml / hr, about 750 ml / hr, about 1,000 ml / hr, about 1,250 ml / hr, about 1,500 ml / hr, about 2,000 ml / hr, about 3,000 ml / hr, about 4,000 ml / hr, about 5,000 ml / hr, about 6,000 ml / hr, about 7,000 ml / hr, about 8,000 ml / hr, and about 9,000 ml / hr. It is also understood that the particular predetermined extrusion rate can depend on the syringe volume, the container volume, the pump actuation speed, etc. It is also understood that this parameter can be selected for a particular application and component.

[0249] An exemplary electrospinning system 500 is shown in Figure 5. Such an exemplary system can include an electrospinning solution 504. The electrospinning solution 504 can include silk fibroin at various concentrations. The solution is pumped into a syringe 502 by a syringe pump 506 and extruded through at least one spinneret (e.g., needle) onto a substrate, which can be positioned on a rotating drum 512. In this exemplary embodiment, a high voltage 508 is supplied to the at least one spinneret, and the rotating drum is grounded.

[0250] FIG. 6 illustrates an exemplary electrospinning system in different embodiments. This diagram shows a system 600 for applying electrospinning material 602 to a stent frame 604. System 600 includes a source 606 of electrospinning material, a collector 608, and a controller 610. The source of electrospinning material can be any suitable device, such as a device including a spinneret electrically coupled to a voltage source. In some embodiments, the voltage source can be electrically coupled to at least one syringe needle. As used herein, the term "syringe pump" can include a combination of a syringe pump, a syringe, and at least one syringe needle, as made clear by the context. However, it is further understood that needleless spinneret systems can also be utilized. A detailed description of these embodiments is included below.

[0251] In these exemplary, non-limiting embodiments, the source of electrospinning material can include at least one syringe pump, at least one syringe mounted on the at least one syringe pump, and at least one syringe needle fluidly coupled to the at least one syringe, where the at least one syringe needle is a spinneret. However, it is understood that this description is merely exemplary and not limiting. In certain embodiments, the source of electrospinning material can include an assembly including multiple spinnerets. In certain embodiments, the multiple spinnerets can include two or more needle spinnerets. In certain exemplary embodiments, these two or more needle spinnerets can be concentrically arranged to enable the formation of composite fibers, for example, as disclosed above. It is understood that composite fibers can include a side-by-side configuration, a sheath-core configuration, a trilobal configuration, an islands-in-the-sea configuration, a split-pie configuration, or any combination thereof. In such embodiments, the spinnerets can be configured and arranged to obtain a desired configuration of the final fiber. In embodiments where the composite fiber has a sheath-core configuration, the spinnerets can be concentrically arranged such that the inner spinneret can be connected to an electrospinning solution containing silk fibroin, while the outer spinneret can be connected to an electrospinning solution containing any of the polymers disclosed herein, with the understanding that the resulting composite fiber will include a core comprising electrospun silk fibers and a sheath comprising any of the other polymers disclosed herein.In such exemplary embodiments, the composite fibers are deposited by electrospinning through at least two concentric spinnerets, the outer spinneret configured to extrude sheath fibers from a fourth solution comprising a fourth predetermined concentration of silk fibroin, and the inner spinneret configured to extrude core fibers at a predetermined extrusion rate from a fifth solution comprising a predetermined concentration of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.However, it should be understood that the above-disclosed treatments are merely exemplary and that the sheath of the bicomponent fiber may be made of one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefins such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. It is understood that the core of the composite fiber can comprise one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. The predetermined extrusion can be at any extrusion rate, as disclosed above.

[0252] In still other aspects, multi-needle spinnerets can be arranged to simultaneously extrude fibers from different electrospinning solutions or from the same electrospinning solution. In such exemplary aspects, the multi-needle spinneret needles can be arranged in any configuration that achieves the desired results. For example, without limitation, the multi-needle spinnerets can be arranged in parallel or in series. In still further aspects, each of the multi-needle spinnerets can have the same diameter extrusion opening, or can vary depending on the desired results.

[0253] In still further embodiments, the assembly may include multiple needleless spinnerets. In these exemplary, non-limiting embodiments, a variety of static and rotary needleless spinnerets may be utilized. Any needleless spinneret known in the art may be used. Some exemplary embodiments including needleless spinneret assemblies are shown in Figures 8-9 (Non-Patent Document 11).

[0254] For example, Figure 8 summarizes rotating spinnerets 802, 804, 806, 808, 810, 812, and 814, all connected to a high-voltage power supply 840 and a spinning solution 820. For electrospinning of cylindrical 812, spherical 814, disk-shaped 808, spiral 810, and beaded chain 806 nanofibers, the spinnerets can be immersed in an electrospinning solution containing any of the polymers disclosed herein. Nanofibers are electrospun upward at the desired support. In such embodiments, the support can be positioned directly on a rotating drum or can comprise any of the frames disclosed herein, handled by specially designed holders and / or spacers. The rotation of the spinnerets carries the polymer solution to the electrospinning site, ensuring continuous production. For roller 802 and cone 804 (spinning using DC motor 830) electrospinning, the spinning solution is pumped from a separate solution reservoir.

[0255] It is understood that needleless electrospinning can rely on the initiation of a jet from an open liquid surface. When a static spinneret is used, a conical spike is often created with the aid of external forces such as magnetic forces, high-pressure gas flow, and gravity. An art-known static needleless spinneret that can be used in embodiments disclosed herein is shown in FIG. 9. For example, a vessel 902 containing the electrospinning solution can be electrically connected to a high voltage 940, and high-pressure nitrogen gas 960 is released into the solution to create a solution bubble 922 and initiate electrospinning. A static cylindrical spinneret 904 having a solution layer 924 thereon can be utilized. Additional examples can include a bowl-shaped spinneret 906 with electrospinning solution 920, a plate-shaped spinneret 908 that can be gravity coupled to a solution container 930 to obtain electrospinning solution 920, a conical wire spinneret 910 with electrospinning solution 920 flowing through the cone, or a container spinneret with a magnet 955 coupled to a high voltage 940 and containing magnetic fluid 950 and electrospinning solution 920. However, it is understood that such needleless spinnerets are merely exemplary and not limiting, and any other spinneret known in the art can be utilized.

[0256] It is further understood that the type of spinneret used to form the materials disclosed herein can be selected based on the desired application or scalability of the process. It is understood that needleless spinnerets can provide greater fiber output compared to needle electrospinning (e.g., cylindrical spinnerets can provide about 8.6 g / hr, disc-shaped spinnerets can provide about 6.2 g / hr, and spherical spinnerets can provide about 3.1 g / hr).

[0257] Furthermore, the specific choice of spinneret can be determined by additional parameters. In some embodiments, if fibers with a finer average diameter are desired, a disk-shaped needleless spinneret can be used (257±77 nm). Such a spinneret can provide fibers with a narrower diameter distribution compared to spherical spinnerets (344±105 nm) and cylindrical spinnerets (357±127 nm).

[0258] In yet a further embodiment, the extrusion spinneret can be positioned within at least a portion of the annular frame's interior space, the interior space being defined by the periphery of the annular frame's inner surface. In such an exemplary embodiment, at least one additional extrusion spinneret is also positioned outside the annular frame. Such an exemplary embodiment is shown in FIG. 11 . Referring to FIG. 11 , an apparatus 1100 is seen that includes an annular frame 1102 and a holder 1104 configured to hold the annular frame 1102 at a predetermined height and to rotate the annular frame 1102 at a desired orientation and speed. In this exemplary apparatus, at least one extrusion spinneret 1108 is positioned within the annular frame's interior space at a third distance from the annular frame and configured to be moved within the annular frame's interior space. In yet another embodiment, the holder 1104 is configured to move the annular frame relative to the spinneret 1108 to achieve the desired third distance. An additional extrusion spinneret 1106 is positioned outside the annular frame at a fourth predetermined distance, it being understood that the third and fourth predetermined distances may be adjustable by moving the extrusion spinneret and / or the annular frame relative to one another.

[0259] In certain embodiments, electrospinning can occur simultaneously from spinnerets 1108 and 1106, while in other embodiments, a fiber is first electrospun from spinneret 1106 and then electrospun from spinneret 1108. However, it is understood that embodiments are also disclosed in which a fiber is first electrospun from spinneret 1108 and then electrospun from spinneret 1106. In some embodiments, electrospinning of a fiber can occur in a cyclical manner. For example, without limitation, a cycle of electrospinning from spinneret 1108 can be followed by electrospinning from spinneret 1106, then again by electrospinning from spinneret 1108, etc. It is understood that the reverse order of using the spinnerets is also disclosed. It is also understood that the duration of each cycle can be determined by the specific characteristics of the desired fiber, material thickness, material density, etc.

[0260] In some embodiments, spinnerets 1108 and 1106 can be connected to the same pump, while in other embodiments, spinnerets 1108 and 1106 can be assembled separately. It is understood that additional spinnerets can be added to the interior space of the annular frame and / or on the outside of the annular frame. It is also understood that any of the spinnerets disclosed herein can be utilized.

[0261] Referring back to Figure 6, in one embodiment, the electrospun material 602 is a solution of silk fibroin (SF). The SF solution can be created by mixing, for example, greater than about 0% to less than about 100% by weight of SF with a suitable solvent or mixture of solvents, such as 2,2-trifluoroacetic acid (TFA) solvent, or by forming an acid, a mixture of formic acid and CaCl, or a mixture of hexafluoroisopropanol (HFIP) and formic acid.

[0262] However, it is understood that this is merely an exemplary solvent and that any other solvent can be used. The concentration of silk fibroin in the solvent can be greater than 0% to less than 50% by weight, including exemplary values ​​of about 0.1 wt%, about 0.2 wt%, about 0.3 wt%, about 0.5 wt%, about 0.6 wt%, about 0.7 wt%, about 0.8 wt%, about 0.9 wt%, about 1 wt%, about 2 wt%, about 3 wt%, about 4 wt%, about 5 wt%, about 6 wt%, about 7 wt%, about 8 wt%, about 9 wt%, about 10 wt%, about 15 wt%, about 20 wt%, about 25 wt%, about 30 wt%, about 35 wt%, about 40 wt%, and about 45 wt%. It is understood that silk fibroin can be present at any value between the above values. In certain embodiments, the silk fibroin can be completely dissolved in the solvent, while in other embodiments, the silk fibroin can form a saturated solution. It is also understood that as the polymer concentration increases, the average diameter of the fibers also increases.

[0263] Furthermore, as disclosed herein, any one of the polymers disclosed herein can be added to a solution of silk fibroin at any desired concentration. For example, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefins such as polypropylene, polyether ether ketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof can be added to a solution containing silk fibroin. Any of the disclosed polymers can be dissolved in any solvent known in the art. For example, the solvent used herein may include 2,2-trifluoroacetic acid (TFA), dichloromethane (DCM), chloroform, methanol, formic acid, acetic acid, or chlorophenol, or any combination thereof. It is also understood that, as described herein, in certain embodiments, one or more alternative electrospinning solutions may be utilized. In such embodiments, any of the polymers disclosed herein may be present in these alternative electrospinning solutions. The use of alternative electrospinning solutions having various combinations of polymers and their concentrations may allow for more precise control of the desired properties of the materials used to form the implantable devices disclosed herein. Additionally, one or more drugs and / or bioactive components may be added to any of the solutions described herein.

[0264] In certain exemplary embodiments, the stent 604 can be any frame disclosed herein or known in the art. The stent 604 can be an expandable stainless steel stent, a polymeric stent, or a nitinol stent. As disclosed, the material is not limited and can include other materials, such as cobalt-chromium alloys.

[0265] An exemplary syringe pump 606 serves as a source of electrospun material 602 that is applied to frame 604. As disclosed in detail above, some embodiments may include multiple syringe pumps. Generally, electrospinning uses an electric charge to draw very fine (typically micrometer- or nanometer-scale) fibers from a liquid, such as a polymer solution or melt. In one electrospinning method, a polymer is expelled through a charged orifice toward a target, with the orifice and target having opposite charges. A voltage source is provided that creates a first charge at the charged orifice and an opposite charge at the target. The polymer is electrostatically charged by contact with the charged orifice. The electrostatically charged polymer is then collected at the target. Electrospinning of materials other than silk fibroin, such as PET and PTFE, is described in U.S. Patent Nos. 6,275,999 and 6,329,723, the contents of both of which are incorporated herein by reference in their entirety. Various aspects of the syringe pump 606, syringe needle, collector 608, control device 610, or mandrel 648 are also described in U.S. Patent No. 6,223,999, the contents of which are incorporated by reference herein in their entirety.

[0266] Electrospun material 602 is electrostatically drawn from the spinneret tip (not shown) by placing or applying a high voltage or potential difference between the spinneret tip and collector 608 using a high voltage power supply 630 coupled to the spinneret and collector by electrical wires 632. In some embodiments, high voltage power supply 630 is a DC power supply of about 5 kV to about 50 kV, with exemplary values ​​of about 10 kV, about 15 kV, about 20 kV, about 25 kV, about 30 kV, about 35 kV, about 40 kV, and about 45 kV. In specific embodiments, high voltage power supply 630 is configured to apply any voltage within the recited range of values ​​to achieve the desired value.

[0267] It is understood that in certain embodiments, fiber diameter, fiber porosity, and mechanical strength can be controlled by the magnitude of the voltage applied by the system and also by the particular polarity applied to the collector and spinneret. It is understood that the higher the applied voltage, the smaller the average diameter of the resulting fibers. Also, in certain exemplary embodiments, finer fibers with a substantially uniform diameter (smaller standard deviation) can be obtained when the collector has negative polarity and the spinneret has positive polarity.

[0268] Referring back to Figure 6, in this example embodiment, a collector 608 can include a base 634 configured to hold a rotary tool 636 at a first end 638 and a rotary holder 640 at a second end 642. An example mandrel 648 can be placed on the collector 608 by placing a first end 650 of the mandrel into the rotary holder and rotary tool.

[0269] In certain embodiments, exemplary electrospinning systems such as those shown in Figures 5 and 6 can be used to form the inner and outer skirts. The frame can be placed on a rotating drum directly or using a mandrel or any holder known in the art. Various such holders and spacers are disclosed in U.S. Patent Nos. 5,629,999 and 5,729,999, which are incorporated herein by reference.

[0270] FIG. 7A shows an exemplary electrospinning system 700 that can be used to create a valve leaflet structure. In this exemplary, non-limiting embodiment, a solution container 702 containing any of the previously disclosed polymers can be utilized. A high voltage 709 can be applied to a needle spinneret 704, and fibers can be electrospun onto a mandrel 706 having a desired shape, such as the shape of a valve leaflet structure. In certain embodiments, the valve leaflet structure can also be formed by electrospinning any of the fibers disclosed herein to form a third material to obtain a sheet of fibrous material ( FIG. 7B ). The desired valve leaflet structure can then be laser cut or ultrasonically cut. It is understood that using a laser cutter or ultrasonic cutter is merely exemplary, and any other method can be used. It is also understood that in certain embodiments, the inner skirt and / or outer skirt can also be formed from a sheet of fibrous material. In such embodiments, the cut inner skirt and / or outer skirt can then be attached to a frame with fasteners. In such exemplary embodiments, the fasteners may comprise adhesive, or sutures, or any other suitable fastener known in the art.

[0271] It is also understood that the properties of the electrospun material can be varied by varying various electrospinning parameters. For example, in certain embodiments, during electrospinning of at least a portion of the plurality of fibers to form the first material and / or the second material, at least a portion of the inner or outer surface of the annular frame is positioned a first predetermined distance or a second predetermined distance, respectively, from at least one extrusion spinneret. Similarly, in other embodiments, during electrospinning of at least a portion of the plurality of fibers to form a third material, at least a portion of a third predetermined mandrel can be positioned a third predetermined distance from at least one extrusion spinneret. The first predetermined distance, the second predetermined distance, and / or the third predetermined distance can be the same or different, depending on the desired properties, and can range from about 0.1 cm to about 200 cm, with exemplary values ​​of about 0.5 cm, about 1 cm, about 5 cm, about 10 cm, about 20 cm, about 50 cm, about 100 cm, about 125 cm, about 150 cm, and about 175 cm. It is understood that larger fibers can be obtained at shorter distances.

[0272] In certain embodiments, as disclosed herein, at least a portion of the annular frame can be positioned on a rotating drum configured to rotate at a predetermined speed. In such embodiments, the predetermined speed can be greater than 0 rpm to about 1,200 rpm, including exemplary values ​​of about 5 rpm, about 10 rpm, about 20 rpm, about 50 rpm, about 100 rpm, about 200 rpm, about 300 rpm, about 400 rpm, about 500 rpm, about 600 rpm, about 700 rpm, about 800 rpm, about 900 rpm, about 1,000 rpm, and about 1,110 rpm. In still further embodiments, the mandrel used to form the valve leaflet system can be stationary or rotating. If the mandrel rotates, the predetermined speed of the mandrel can also be greater than 0 rpm to about 1,200 rpm, including exemplary values ​​of about 5 rpm, about 10 rpm, about 20 rpm, about 50 rpm, about 100 rpm, about 200 rpm, about 300 rpm, about 400 rpm, about 500 rpm, about 600 rpm, about 700 rpm, about 800 rpm, about 900 rpm, about 1,000 rpm, and about 1,110 rpm. It is further understood that the mechanical and scaffolding properties of the formed material can also be controlled by varying the rotation speed of the drum. For example, when the drum / mandrel is rotated slowly, the fibers may have a random orientation, while in other embodiments, when the drum / mandrel is rotated more quickly, a more aligned orientation of the fibers may be obtained.

[0273] In still further embodiments, it is understood that multiple different parameters can be used simultaneously to control the desired mechanical and scaffolding properties of the materials disclosed herein. For example, in one embodiment, a first plurality of fibers can be formed with a larger drum rotation combined with a higher voltage and a greater distance, and then a second plurality of fibers can be formed by slowing the drum rotation, reducing the voltage, and / or shortening the distance between the drum collector and the extrusion spinneret. It is understood that such manipulation of processing conditions can be used to obtain a desired average diameter of the fibers and porosity of the formed material.

[0274] It is also understood that the material formed by the disclosed method can be a scaffold material.Cell growth in the material disclosed herein can also be controlled by controlling the average diameter of the fibers and the porosity of the material.Similarly, skilled practitioners can adjust the biodegradability and biodegradation rate of the formed material by precisely controlling and optimizing the average diameter and porosity of the fibers.

[0275] In yet further embodiments, a semi-liquid electrospinning process can be utilized to increase the mechanical strength of the fiber. In such exemplary embodiments, the first plurality of layers can be electrospun when the collector is positioned close enough to prevent the solvent present in the electrospinning solution from evaporating before the electrospun fiber is formed on the collector. In such exemplary embodiments, the formed fiber is "semi-liquid." Furthermore, after forming the first plurality of layers, the collector can be moved far enough to allow the solvent present in the electrospinning solution to evaporate before the electrospun fiber is formed on the collector, and far enough to form a "dry fiber." This sequence of forming different layers can be repeated as needed. Nevertheless, in other embodiments, a similar effect can be achieved by varying the extrusion speed. For example, without limitation, the first plurality of layers can be deposited at a high extrusion speed, followed by forming a second plurality of layers deposited at a low extrusion speed. Without wishing to be bound by any theory, it is hypothesized that during "semi-liquid" to "dry" electrospinning, the remaining solvent penetrates the various layers, improving the interconnection between the layers and thus the overall strength of the material.

[0276] In still further embodiments, the first, second, and / or third materials can be chemically or physically treated to improve their mechanical strength. In some embodiments, plasma treatment of the materials can be applied, as previously disclosed. In such exemplary embodiments, the plasma treatment can activate free radicals in the substrate, which can crosslink and form bonds between polymer chains in the deposited layer or nanofiber layer to increase strength and change the hydrophilicity / hydrophobicity of the material, as previously disclosed.

[0277] In still further aspects, heat treatment can be used, while in still other aspects, freezing and thawing processes can be utilized, and in still further aspects, controllable welding can be used to improve the mechanical properties of the material.

[0278] Still further, as disclosed herein, an adhesive material may be applied to at least a portion of the annular frame prior to attaching at least a portion of the first material and / or second material to at least a portion of the annular frame, while in other aspects, at least a portion of the annular frame may be plasma treated prior to forming the inner skirt and / or outer skirt.

[0279] As disclosed herein, multiple fiber undulations may also be formed.

[0280] In still further aspects, as disclosed herein, the first material, second material, and / or third material can be formed on separate predetermined mandrels and then shaped to desired dimensions.

[0281] In some embodiments, any or all of the first, second, and / or third materials may further comprise at least one porous material. In such embodiments, the electrospun fibers may be disposed in the at least one porous material.

[0282] It is understood that at least one perforated material may be disposed on a surface of the electrospun fibers. In some embodiments, for example, when forming an inner skirt, at least one perforated material may be disposed on a surface facing the annular frame, while in other embodiments, at least one perforated material may be disposed on a surface facing the inner portion of the frame. Similarly, when forming an outer skirt, the perforated material may be disposed on a surface facing the annular frame or on a surface facing the subject's natural anatomy.

[0283] In still other embodiments, the third material may also include at least one perforated material that may be disposed on either or both surfaces of the third material.

[0284] It is understood that any combination of various configurations can be formed. For example, the first material can include at least one perforated material, while the second and third materials do not. In still other examples, only the second material can include at least one perforated material. Meanwhile, in still other examples, both the first and second materials can include at least one perforated material. In still further examples, all three materials can include at least one perforated material, and so on. In still further embodiments, two or more perforated materials can be utilized. In some embodiments, multiple fibers can be sandwiched between perforated materials. In such embodiments, two perforated materials and multiple fibers can be bonded to each other. In still further embodiments, two or more layers of perforated material can be used on each or any surface of the materials disclosed herein. Any of the perforated materials disclosed herein can be utilized.

[0285] In some embodiments, multiple fibers of a first material, a second material, and / or a third material can be electrospun directly onto at least one porous material. In still other embodiments, multiple fibers of a first material, a second material, and / or a third material can be attached to at least one porous material by any means known in the art. In some embodiments, attachment can be with fasteners, such as adhesives or sutures. In still other embodiments, multiple fibers can be heat-pressed onto the porous material. In some embodiments, attachment can occur at any portion of the porous material. For example, in some embodiments, attachment can occur throughout the entire surface of the porous material, while in other embodiments, attachment can occur only at one or more edges of the porous material, or anywhere on the surface of the porous material in any desired pattern. It is understood that the placement of the attachment and the amount of surface area physically attached to the multiple fibers can vary depending on the desired application.

[0286] In still further embodiments, as previously disclosed, the first material, second material, and / or third material may include at least one auxiliary layer. Any of the auxiliary layers previously disclosed may be utilized. Similarly, an auxiliary layer may be disposed on any surface of any of the materials disclosed herein. In some embodiments, the auxiliary layer may be coated, sprayed, solution-deposited, or applied by any other method known in the art. In some embodiments, both a perforated material and an auxiliary layer are present. In such embodiments, attachment between all layers may occur throughout the entire material, through one or more edges, or in any pattern as desired.

[0287] An alternative embodiment for forming the disclosed implantable devices and materials is shown in FIGS. 10A-10B. In such an implementation, a fibrous material can be applied to a medical implant device using a rotary jet spinning process rather than electrospinning. For example, with respect to certain prosthetic heart valve implant devices, a fibrous material can be applied to a metal stent structure, and the applied fibrous material can serve to reduce friction between the stent and a particular biological structure (e.g., vessel / opening) at the implantation site, secure the implant device at the implantation site, fill gaps through which fluids can pass, and / or provide a surface for tissue ingrowth. The application of rotary jet spinning of fibrous material represents another example of how to apply a braid or fibrous material (e.g., a polymeric fibrous material) to the surface of a stent or other medical device implant component in a manner that can reduce labor hours and fabrication costs. Using the illustration, rotary jet spun material can be applied to a medical device implant (e.g., a metal stent) while the implant and support retainer are rotated by a rotary tool. Over time, the rotary jet spinning process can produce a layer of polymer threads or fibers that coat the exterior of a target surface. Rotary jet spinning generally does not require the use of any electric field, unlike electrostatic spinning. Rotary jet spinning can involve the conversion of a material (e.g., a polymer) dissolved in a solvent into continuous fibrous threads / fibers by centrifugal ejection of the material / solvent at high speeds so that the ejected threads / fibers at least partially cover or are otherwise applied to the target surface, as described in more detail below. For example, the target surface can comprise the surface of a medical device component (e.g., a stent / frame), which can be rotated to coat different surface areas. Particular methods, devices, and systems related to the rotary jet spinning concept that may be applicable to embodiments of the present disclosure are disclosed in U.S. Patent Application Publication No. 2009 / 0129994, the disclosure of which is hereby incorporated by reference in its entirety.

[0288] Rotary jet spinning systems and processes can involve imparting a rotational motion to a container holding any of the previously disclosed polymer solutions, causing the polymer to be expelled from one or more openings in the container. Such processes can further involve collecting the formed fibers in a holder having a desired shape to form micron-, submicron-, or nanometer-sized polymer fibers as a coating for a medical implant device component. FIG. 10A shows a system 1000 for applying rotary jet spinning material 85 to a stent or other medical implant device component 73 coupled to a holder component 70 associated with a rotating mandrel 75. The system 1000 can include a rotary motor (e.g., a pneumatic motor) 86 that can be configured to drive the rotation of the container 80. The container 80 is shown enlarged in FIG. 10B. In some embodiments, the polymer solution is extruded through a small opening 89. The extrusion of the solution can generate a plane 81 of fibers 85 that the rotating holder 70 moves in and out of during the collection process in a desired translational order.

[0289] Rotation of the mandrel 75 and holder 70 may be driven by a motor 11. Additionally, the mandrel 75 and holder 70 may be mounted on a linear motor 12 configured to effect vertical translation of the mandrel 75 and holder 70. The motor 12 may be considered a fiber plane translation motor and may, for example, comprise a high uniaxial precision linear drive configured to translate the collector assembly 79 along an axis 13 parallel to the axis of rotation 83 of the rotating vessel 80, which translation corresponds to a translation vertical to the illustrated orientation of FIG. 10A . The axis 83 may also be referred to as the deposition axis of rotation. In certain embodiments, one or more additional linear drives may be used to translate the rotating mandrel 75 and holder 70 along one or more axes perpendicular to the axis of rotation 83 of the rotating vessel (e.g., movement toward and away from the deposition axis of rotation 83). In some embodiments, a multi-axis drive or robotic arm may be used to provide increased flexibility in translation and / or altering the angular alignment of holder 70.

[0290] Mandrel 75 and holder 70 may represent components of a collection assembly 79 that can be at least partially inserted into the path / plane 81 of polymer fiber 85. The axis 14 about which mandrel / holder 70 is rotated may be referred to as the collection axis of rotation or the mandrel / holder axis of rotation. When holder 70 is in the path / plane 81 of polymer fiber 85 emerging from rotating vessel 80, as holder 70 is translated along axis 13, polymer fiber 85 may become wrapped around holder 70 via rotation of holder 70 about collection axis of rotation 14.

[0291] In one embodiment, a method for depositing a fibrous material on a medical implant device component involves feeding any of the polymers disclosed herein into a rotating vessel 80, generating a rotational motion at a speed and time sufficient to form micron-, submicron-, or nanometer-sized polymer fibers, and collecting the formed fibers on the medical implant device to form micron-, submicron-, or nanometer-sized polymer fibers coating the desired shape / configuration. In one embodiment, the fibrous threads are generated by exposing the polymer solution to a sufficient amount of pressure / stress for a sufficient time to form a fibrous coating in the desired shape / configuration on one or more components of the medical implant device. For example, the pressure / stress sufficient to generate the fibrous threads from the polymer solution can be about 3,000 Pascals or greater.

[0292] In one embodiment, system 1000 is at least partially automated by control circuitry 5 configured to control one or more of the rotational speed of container 80, the rotational speed of holder 70, and the linear and / or multi-dimensional translation of holder 70 along axis 13 parallel to the rotation axis 83 of the rotating container and / or one or more other axes through the generation and / or transmission of electrical signals to one or more components of system 1000.

[0293] Control over the rate of translation of the retainer 70 along axis 13 and / or the orientation of the collection axis 14 relative to the container rotation axis 83 can provide at least partial control over the orientation of the fibers deposited on the collection retainer 70. For example, fibers can be collected with the retainer 70 substantially parallel to the container rotation axis 83 by slow translation along the collection rotation axis 14. In some implementations, the rotation of the collection device (e.g., retainer 70) can be opposite to the rotation of the container 80 (e.g., counterclockwise and clockwise, respectively), or the rotation of the collection device 70 can be the same as the rotation of the container 80 (e.g., both counterclockwise). In some implementations, slowly moving the collection device (e.g., retainer 70) along axis 13 through the path of the polymer fibers 85 while rotating the collection device / assembly 70 maintains perfectly aligned coverage of the retainer and / or medical device components.

[0294] As shown in FIG. 10A , the collection axis of rotation 14 can be oriented at an angle θ relative to the deposition axis of rotation. Such a configuration can result in fiber collection at the collection assembly 70 with crossed polymer fibers. By increasing the speed of translation and / or rotating the holder 70 at a non-zero angle θ relative to the deposition axis of rotation, crossed weaves can be generated. Collection assemblies as disclosed herein can be moved manually or mechanically.

[0295] In one embodiment, the system 1000 includes a platform 10 for directing the deposition of fibrous material, with a deposition assembly (80, 86) and a collection assembly (70, 71, 73, 76, 11) positioned vertically above the platform 10 and / or spaced apart from the platform 10 along a vertical axis 13. The rotational speed and time sufficient to operate the rotating structure 80 to form fibers can depend on the concentration of the material / solution and the desired characteristics of the formed fibers. Exemplary speeds of rotation of the rotating structure can range from about 100 rpm to about 500,000 rpm, although the rotational speed is not limited to this exemplary range. Furthermore, the rotating structure 80 can be rotated to affect the liquid material for a time sufficient to form the desired fibers, such as, for example, a length of time between about 1 minute and 100 minutes, although other intermediate times or ranges are also contemplated as part of this disclosure. The force or energy imparted by the rotating structure 80 advantageously overcomes the surface tension of the solution, disrupting a portion of the liquid material at the meniscus and flinging the portion from contact with the rotating structure and from a platform (not shown) on which the liquid is maintained, thereby forming fibers. The fibers may be collected in the collection device 70. In some embodiments, the direction in which the liquid material is flung may be substantially the same as a tangent direction to the motion of the rotating structure of the container 80 in contact with the liquid material. In some embodiments, the rotating structure may impart a force to the liquid material in a direction substantially parallel to the top surface of the liquid material.

[0296] Any suitable size or geometric shape of vessel 80 or collector 70 can be used to fabricate / collect polymer fibers. For example, vessel 80 can be tubular, conical, semicircular, bicuspid, circular, rectangular, or oval. Retainer 70 can be circular, oval, rectangular, or half-heart shaped. Retainer 70 can be shaped in the form of any biological organ, such as a heart, kidney, liver lobe, bladder, uterus, intestine, skeletal muscle, lung, or portion thereof. Retainer 70 can also be shaped as any hollow cavity, organ, or tissue, such as a circular muscle structure, e.g., a valve, sphincter, or iris.

[0297] The collection device 70 can be a holder configured in any desired shape and can be positioned in the path of the polymer being released from one or more openings or the path of the fibers being thrown from the rotating structure 80. In certain embodiments, the collection device 70 can be positioned at a distance of about 2 inches (about 5 cm) to about 12 inches (about 30 cm) from the container 80 from which the polymer is being released. Specific exemplary distances can include, but are not limited to, 2 inches, 3 inches, 4 inches, 5 inches, 6 inches, 7 inches, 8 inches, 9 inches, 10 inches, 11 inches, 12 inches (5 cm, 7.6 cm, 10.2 cm, 12.7 cm, 15.2 cm, 17.8 cm, 20.3 cm, 22.9 cm, 25.4 cm, 27.9 cm, 30 cm), and all intermediate values. This distance can be selected and / or configured to avoid the formation of fibrous beads (which may occur if the collection device 70 is too close to the container 80) and to achieve sufficient fiber collection (which may not occur if the collection device is too far from the container). In some implementations, the formation of fibrous beads is intentionally performed to provide desired fiber properties. Nevertheless, other exemplary embodiments for forming various implantable devices utilizing a rotary jet spinning system can be found in U.S. Patent Application Publication No. 2007 / 0122999, the contents of which are incorporated herein in their entirety.

[0298] Illustrative Embodiments Example 1: An implantable prosthetic valve comprising: an annular frame having inner and outer surfaces, and having inflow and outflow ends and a central longitudinal axis extending from the inflow end to the outflow end; a leaflet structure positioned within the frame; an inner skirt positioned along the inner surface of the frame; and at least one outer skirt positioned around the outer surface of the frame, wherein at least a portion of one of the leaflet structure, the inner skirt, or the at least one outer skirt comprises a material comprising a plurality of fibers, and at least one fiber of the plurality of fibers comprises electrospun silk; and the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0299] Example 2: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 1, wherein at least a portion of the inner skirt comprises a material having a plurality of fibers, the material present on at least a portion of the inner skirt being a first material, the first material having a first surface facing the annular frame and an opposing second surface.

[0300] Example 3: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 1 or Example 2, wherein at least a portion of the outer skirt comprises a material having a plurality of fibers, and the material present on at least a portion of the outer skirt is a second material, the second material having a first surface facing the annular frame and an opposing second surface.

[0301] Example 4: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-3, wherein at least a portion of the leaflet structure comprises a material including a plurality of fibers, and the material present in at least a portion of the leaflet structure is a third material, and the third material has a first surface facing the annular frame and an opposing second surface.

[0302] Example 5: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 4, wherein the first material, the second material, and the third material are the same or different.

[0303] Example 6: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1 to 5, wherein each fiber of the plurality of fibers has a first extension direction and a plurality of undulations.

[0304] Example 7: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 6, wherein the first direction of extension comprises a circumferential direction, a radial direction, or a combination thereof.

[0305] Example 8: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 6 or Example 7, wherein the plurality of undulations are present in a collapsed configuration.

[0306] Example 9: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 6-8, wherein the plurality of undulations are configured to straighten when the implantable prosthetic valve is in the expanded configuration.

[0307] Example 10: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-9, further comprising an adhesive material disposed between at least a portion of the annular frame and at least a portion of the outer skirt, and / or between at least a portion of the annular frame and at least a portion of the inner skirt.

[0308] Example 11: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 3-10, wherein at least a portion of the inner skirt is attached to the annular frame by direct electrospinning of a plurality of fibers onto at least a portion of the inner surface of the annular frame.

[0309] Example 12: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 4-11, wherein at least a portion of the outer skirt is attached to at least a portion of the annular frame by direct electrospinning of a plurality of fibers onto at least a portion of the outer surface of the annular frame.

[0310] Example 13: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-12, wherein at least a portion of the plurality of fibers have a random orientation.

[0311] Example 14: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-13, wherein at least a portion of the plurality of fibers have a predetermined side-by-side orientation.

[0312] Example 15: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-14, wherein the plurality of fibers further comprises an absorbable material, a non-absorbable material, or any combination thereof.

[0313] Example 16: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-15, wherein at least one fiber of the plurality of fibers further comprises thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0314] Example 17: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-16, wherein the plurality of fibers comprises composite fibers.

[0315] Example 18: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 17, wherein the composite fibers comprise a side-by-side configuration, a sheath-core configuration, an islands-in-the-sea configuration, a trileaflet configuration, a split-pie configuration, or any combination thereof.

[0316] Example 19: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 18, wherein the composite fiber comprises a sheath-core configuration.

[0317] Example 20: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 19, wherein the sheath and / or core of the composite fiber comprises an absorbable material, a non-absorbable material, or any combination thereof.

[0318] Example 21: The sheath of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof, and the core of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 19 or Example 20, comprises one or more of: thiazolinone (TPU), polyurethane (PU), implantable elastane, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0319] Example 22: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 19-21, wherein the composite fiber sheath comprises silk and the composite fiber core comprises one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0320] Example 23: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1 to 22, wherein the plurality of fibers have an average diameter of about 3 nm to about 15,000 nm.

[0321] Example 24: An implantable prosthetic valve of any example herein, particularly an implantable prosthetic valve of Examples 2 to 23, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits porosity.

[0322] Example 25: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 24, wherein at least a portion of the first material, and / or the second material, and / or the third material has an average pore size of about 100 nm to about 100 μm.

[0323] Example 26: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 through 25, wherein the first material, and / or the second material, and / or the third material comprises multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers is disposed on top of one another.

[0324] Example 27: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 26, wherein at least a first portion of the plurality of layers has a surface area that is substantially less than a surface area of ​​a second portion of the surface area of ​​the plurality of layers.

[0325] Example 28: The implantable prosthetic valve of any of the examples herein, particularly the implantable prosthetic valves of Examples 2 to 27, wherein the first material, and / or the second material, and / or the third material exhibit a tensile strength of greater than 0 MPa to about 20 MPa.

[0326] Example 29: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 28, wherein the first material, and / or the second material, and / or the third material exhibits an elongation at break of greater than 0% to about 600%.

[0327] Example 30: The implantable prosthetic valve of any of the examples herein, particularly the implantable prosthetic valves of Examples 2 to 29, wherein the first material, and / or the second material, and / or the third material exhibit a water contact angle of about 0° to about 180°.

[0328] Example 31: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 1-30, wherein at least a portion of the annular frame is plasma treated.

[0329] Example 32: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2-31, wherein at least a portion of the inner skirt comprising the first material is plasma treated.

[0330] Example 33: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 3-32, wherein at least a portion of the outer skirt comprising the second material is plasma treated.

[0331] Example 34: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 4-33, wherein at least a portion of the leaflet structure comprising the third material is plasma treated.

[0332] Example 35: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 34, wherein the first material, and / or the second material, and / or the third material are at least partially biodegradable.

[0333] Example 36: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 35, wherein the first material, and / or the second material, and / or the third material is at least partially bioabsorbable.

[0334] Example 37: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 16 to 36, wherein the first material, and / or the second material, and / or the third material are at least partially degradable.

[0335] Example 38: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 37, wherein the first material, and / or the second material, and / or the third material is a scaffold material.

[0336] Example 39: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 10 or Examples 13 to 38, wherein at least a portion of the inner skirt further comprises a first perforated material having a first surface facing the annular frame and an opposite second surface, and the first material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or the second surface of the first perforated material.

[0337] Example 40: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 3 to 10 or Examples 13 to 39, wherein at least a portion of the outer skirt further comprises a second porous material having a first surface facing the annular frame and an opposite second surface, and the second material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or second surface of the second porous material.

[0338] Example 41: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 4 to 10 or Examples 13 to 40, wherein at least a portion of the leaflet structure comprises a third perforated material having a first surface facing the annular frame and an opposing second surface, and the third material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or the second surface of the third perforated material.

[0339] Example 42: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 39 to 41, wherein the first perforated material, the second perforated material, and / or the third perforated material are the same or different.

[0340] Example 43: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 10 or Examples 13 to 42, wherein at least a portion of the first surface of the first material comprises a first auxiliary layer.

[0341] Example 44: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 2 to 10 or Examples 13 to 43, wherein at least a portion of the second surface of the first material comprises a first auxiliary layer.

[0342] Example 45: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 44, wherein the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0343] Example 46: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 3-10 or 13-45, wherein at least a portion of the first surface of the second material comprises a second auxiliary layer.

[0344] Example 47: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 3-10 or 13-46, wherein at least a portion of the second surface of the second material comprises a second auxiliary layer.

[0345] Example 48: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 47, wherein the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0346] Example 49: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 4 to 10 or Examples 13 to 48, wherein at least a portion of the first surface of the third material comprises a third auxiliary layer.

[0347] Example 50: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 4 to 10 or Examples 13 to 49, wherein at least a portion of the second surface of the third material comprises a third auxiliary layer.

[0348] Example 51: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 50, wherein the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0349] Example 52: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 43 to 51, wherein each of the first auxiliary layer, the second auxiliary layer, or the third auxiliary layer is the same or different.

[0350] Example 53: The first perforated material, the second perforated material, and / or the third perforated material comprise a porous fabric or membrane, and the porous fabric or membrane comprises: Absorbency , Non-absorbable or a combination thereof.

[0351] Example 54: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 41-53, wherein the first porous material, the second porous material, and / or the third porous material comprises a porous braid or membrane, and the porous braid or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymers, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-co-glycolic acid (PLGA), or a combination thereof, or a natural / regenerated fiber selected from cotton, silk, hemp, cellulose acetate, collagen, or a combination thereof.

[0352] Example 55: The implantable prosthetic valve of any of the examples herein, particularly the implantable prosthetic valves of Examples 50 to 53, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer is configured to impart hydrophobicity or hydrophilicity, elasticity, mechanical recovery, mechanical strength, adhesive properties, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first material, the second material, and / or the third material.

[0353] Example 56: The first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are Absorbency material, Non-absorbable The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 55, comprising one or more of the following materials:

[0354] Example 57: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 55 or Example 56, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises one or more thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0355] Example 58: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 39 to 57, wherein at least a portion of the inner skirt further comprises at least two layers of a first porous material, the first material comprising a plurality of fibers being disposed between the two layers of the first porous material, and the two layers of the first porous material being at least partially bonded to each other.

[0356] Example 59: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 40 to 58, wherein at least a portion of the outer skirt further comprises at least two layers of a second porous material, the second material comprising a plurality of fibers being disposed between the two layers of the second porous material, and the two layers of the second porous material being at least partially bonded to each other.

[0357] Example 60: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 41-59, wherein at least a portion of the leaflet structure further comprises at least two layers of a third porous material, the third material comprising a plurality of fibers being disposed between the two layers of the third porous material, and the two layers of the third porous material being at least partially bonded to each other.

[0358] Example 61: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 43, wherein at least a portion of the second surface of the first material is disposed on the first surface of the first porous material.

[0359] Example 62: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 44, wherein at least a portion of the first surface of the first material is disposed on the second surface of the first porous material.

[0360] Example 63: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 46, wherein at least a portion of the second surface of the second material is disposed on the first surface of the second porous material.

[0361] Example 64: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 47, wherein at least a portion of the first surface of the second material is disposed on the second surface of the second porous material.

[0362] Example 65: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 49, wherein at least a portion of the second surface of the third material is disposed on the first surface of the third porous material.

[0363] Example 66: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Example 50, wherein at least a portion of the first surface of the third material is disposed on the second surface of the third porous material.

[0364] Example 67: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 61-66, wherein at least a portion of the first auxiliary layer and the first porous material are bonded to one another.

[0365] Example 68: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 63-67, wherein at least a portion of the second auxiliary layer and the second porous material are bonded to one another.

[0366] Example 69: The implantable prosthetic valve of any example herein, particularly the implantable prosthetic valve of Examples 65-68, wherein at least a portion of the third auxiliary layer and the third porous material are bonded to one another.

[0367] Example 70: An article comprising a material comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk, the article having a collapsed configuration and an expanded configuration, and the article is part of an implantable device.

[0368] Example 71: The article of any example herein, particularly the article of Example 70, wherein the article is a perivalvular leak sealant article.

[0369] Example 72: The perivalvular leak sealing article comprises an inner skirt comprising a first material comprising a plurality of fibers, the inner skirt configured to be positioned on at least a portion of an inner surface of an annular frame of an implantable prosthetic device, the first material having a first surface facing the annular frame and an opposing second surface, any of the examples herein, particularly the article of Example 71.

[0370] Example 73: The perivalvular leak sealing article comprises an outer skirt comprising a second material comprising a plurality of fibers, the outer skirt configured to be positioned on at least a portion of the outer surface of an annular frame of an implantable prosthetic device, the second material having a first surface facing the annular frame and an opposing second surface, the article of any example herein, particularly the article of Example 71 or Example 72.

[0371] Example 74: The article of any of the examples herein, particularly Examples 71-73, wherein the article comprises a leaflet structure including a third material comprising a plurality of fibers, the leaflet structure being configured to be positioned within at least a portion of an annular frame of an implantable prosthetic device, the third material having a first surface facing the annular frame and an opposing second surface.

[0372] Example 75: The article of any example herein, particularly Examples 70-74, wherein the material comprises the first material, or the second material, or the third material, or a combination thereof.

[0373] Example 76: The article of any example herein, particularly Examples 72-75, wherein the first material, second material, and third material are the same or different.

[0374] Example 77: The article of any example herein, particularly the article of Examples 70 to 76, wherein each fiber of the plurality of fibers has a first extension direction and a plurality of undulations.

[0375] Example 78: The article of any example herein, particularly the article of Example 77, wherein the first direction of extension comprises a circumferential direction, a radial direction, or a combination thereof.

[0376] Example 79: The article of any example herein, particularly Example 77 or Example 78, wherein the plurality of undulations are present in a collapsed configuration.

[0377] Example 80: The article of any example herein, particularly Examples 77-79, wherein the plurality of undulations are configured to straighten out when the article is in the expanded configuration.

[0378] Example 81: The article of any example herein, particularly Examples 72-80, wherein at least a portion of the inner skirt is attached to at least a portion of the annular frame by direct electrostatic spinning of a plurality of fibers.

[0379] Example 82: The article of any example herein, particularly Examples 72-81, wherein at least a portion of the outer skirt is attached to at least a portion of the annular frame by direct electrostatic spinning of a plurality of fibers.

[0380] Example 83: The article of any example herein, particularly Examples 70-82, wherein at least a portion of the plurality of fibers have a random orientation.

[0381] Example 84: The article of any example herein, particularly Examples 71-83, wherein at least a portion of the plurality of fibers have a predetermined side-by-side orientation.

[0382] Example 85: A plurality of fibers are Absorbency material, Non-absorbable The article of any example herein, particularly the articles of Examples 71-84, further comprising:

[0383] Example 86: The article of any example herein, particularly the article of Examples 71-85, wherein at least one fiber of the plurality of fibers further comprises thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0384] Example 87: The article of any example herein, particularly Examples 70-86, wherein the plurality of fibers comprises bicomponent fibers.

[0385] Example 88: The article of any example herein, particularly the article of Example 87, wherein the bicomponent fiber comprises a side-by-side configuration, a sheath-core configuration, a trilobal configuration, an islands-in-the-sea configuration, a split-pie configuration, or any combination thereof.

[0386] Example 89: The article of any example herein, particularly the article of Example 88, wherein the bicomponent fiber has a sheath-core configuration.

[0387] Example 90: The sheath and core of a composite fiber are Absorbency material, Non-absorbable The article of any example herein, particularly the article of Example 89, comprising the material, or a combination thereof.

[0388] Example 91: The sheath of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof, and the core of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. The article of any example herein, particularly the article of Example 89 or Example 90, comprising one or more of polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0389] Example 92: The article of any example herein, particularly the article of Example 89, wherein the sheath of the bicomponent fiber comprises silk and the core of the bicomponent fiber comprises one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0390] Example 93: The article of any example herein, particularly Examples 70-92, wherein the plurality of fibers have an average diameter of from about 3 nm to about 15,000 nm.

[0391] Example 94: The article of any of the examples herein, particularly Examples 72-93, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits porosity.

[0392] Example 95: The article of any example herein, particularly the article of Example 94, wherein at least a portion of the first material, and / or the second material, and / or the third material has an average pore size of about 100 nm to about 100 μm.

[0393] Example 96: The article of any of the examples herein, particularly the articles of Examples 72 to 95, wherein at least a portion of the first material, and / or the second material, and / or the third material comprises multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers being disposed on top of one another.

[0394] Example 97: The article of any example herein, particularly the article of Example 96, wherein at least a first portion of the plurality of layers has a surface area that is substantially less than a surface area of ​​a second portion of the surface area of ​​the plurality of layers.

[0395] Example 98: The article of any of the examples herein, particularly Examples 72 to 97, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits a tensile strength of greater than 0 MPa to about 20 MPa.

[0396] Example 99: The article of any of the examples herein, particularly Examples 72 to 98, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits an elongation at break of greater than 0% to about 600%.

[0397] Example 100: The article of any of the examples herein, particularly Examples 72 to 99, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits a water contact angle of about 0° to about 180°.

[0398] Example 101: The article of any example herein, particularly Examples 72-100, wherein at least a portion of the first material comprising a plurality of fibers is plasma treated.

[0399] Example 102: The article of any example herein, particularly Examples 73-101, wherein at least a portion of the second material is plasma treated.

[0400] Example 103: The article of any example herein, particularly Examples 74-102, wherein at least a portion of the third material is plasma treated.

[0401] Example 104: The article of any of the examples herein, particularly Examples 72 to 103, wherein at least a portion of the first material, and / or the second material, and / or the third material is at least partially biodegradable.

[0402] Example 105: The article of any of the examples herein, particularly Examples 72 to 104, wherein at least a portion of the first material, and / or the second material, and / or the third material is at least partially bioabsorbable.

[0403] Example 106: The article of any of the examples herein, particularly Examples 83 to 105, wherein at least a portion of the first material, and / or the second material, and / or the third material is at least partially degradable.

[0404] Example 107: The article of any of the examples herein, particularly Examples 72 to 106, wherein at least a portion of the first material, and / or the second material, and / or the third material is configured to be a scaffold material.

[0405] Example 108: The article of any of the examples herein, particularly Examples 72 to 80 or 83 to 107, wherein at least a portion of the inner skirt further comprises a first perforated material having a first surface facing the annular frame and an opposite second surface, and the first material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or second surface of the first perforated material.

[0406] Example 109: The article of any example herein, particularly the articles of Examples 73-80 or 83-108, wherein at least a portion of the outer skirt further comprises a second perforated material having a first surface facing the annular frame and an opposite second surface, and the second material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or second surface of the second perforated material.

[0407] Example 110: The article of any of the examples herein, particularly the articles of Examples 74 to 80 or Examples 83 to 109, wherein at least a portion of the leaflet structure comprises a third porous material having a first surface facing the annular frame and an opposite second surface, and the third material comprising a plurality of fibers comprising electrospun silk is disposed on the first surface and / or second surface of the third porous material.

[0408] Example 111: The article of any example herein, particularly Examples 108-110, wherein the first perforated material, the second perforated material, and / or the third perforated material are the same or different.

[0409] Example 112: The article of any of the examples herein, particularly the articles of Examples 72-80 or 83-111, wherein at least a portion of the first surface of the first material comprises a first auxiliary layer.

[0410] Example 113: The article of any of the examples herein, particularly the articles of Examples 72-80 or 83-112, wherein at least a portion of the second surface of the first material comprises a first auxiliary layer.

[0411] Example 114: The article of any example herein, particularly the article of Example 113, wherein the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0412] Example 115: The article of any of the examples herein, particularly the articles of Examples 72-80 or 83-114, wherein at least a portion of the first surface of the second material comprises a second auxiliary layer.

[0413] Example 116: The article of any example herein, particularly Examples 72-80 or 83-115, wherein at least a portion of the second surface of the second material comprises a second auxiliary layer.

[0414] Example 117: The article of any example herein, particularly the article of Example 47, wherein the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0415] Example 118: The article of any example herein, particularly the article of Examples 73-80 or 83-117, wherein at least a portion of the first surface of the third material comprises a third auxiliary layer.

[0416] Example 119: The article of any example herein, particularly Examples 73-80 or 83-118, wherein at least a portion of the second surface of the third material comprises a third auxiliary layer.

[0417] Example 120: The article of any example herein, particularly the article of Example 119, wherein the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0418] Example 121: The article of any example herein, particularly the articles of Examples 112-120, wherein each of the first auxiliary layer, second auxiliary layer, or third auxiliary layer is the same or different.

[0419] Example 122: The first perforated material, the second perforated material, and / or the third perforated material comprise a porous fabric or membrane, and the porous fabric or membrane comprises: Absorbency material, Non-absorbable The article of any of the examples herein, particularly the articles of Examples 108 through 121, comprising the material, or a combination thereof.

[0420] Example 123: The article of any example herein, particularly the articles of Examples 108 to 122, wherein the first perforated material, the second perforated material, and / or the third perforated material comprises a porous knit or membrane, and the porous knit or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA), or a combination thereof, or a natural / regenerated fiber selected from cotton, silk, linen, cellulose acetate, collagen, or a combination thereof.

[0421] Example 124: The article of any of the examples herein, particularly the articles of Examples 112 to 123, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are configured to impart hydrophobicity or hydrophilicity, elasticity, mechanical recovery, mechanical strength, adhesiveness, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first material, the second material, and / or the third material.

[0422] Example 125: The first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are: Absorbency material, Non-absorbable The article of any of the examples herein, particularly the article of Example 124, comprising one or more of the materials, or combinations thereof.

[0423] Example 126: The article of any example herein, particularly the article of Example 124 or Example 125, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises one or more thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0424] Example 127: The article of any of the examples herein, particularly the articles of Examples 108 to 126, wherein at least a portion of the inner skirt further comprises at least two layers of a first perforated material, the first material comprising a plurality of fibers comprising electrospun silk being disposed between the two layers of the first perforated material, and the two layers of the first perforated material being at least partially bonded to each other.

[0425] Example 128: The article of any of the examples herein, particularly the articles of Examples 109-127, wherein at least a portion of the outer skirt further comprises at least two layers of a second porous material, the second material comprising a plurality of fibers comprising electrospun silk being disposed between the two layers of the second porous material, and the two layers of the second porous material being at least partially bonded to each other.

[0426] Example 129: The article of any example herein, particularly the articles of Examples 110 to 128, wherein at least a portion of the leaflet structure further comprises at least two layers of a third porous material, the third material comprising a plurality of fibers comprising electrospun silk being disposed between the two layers of the third porous material, and the two layers of the third porous material being at least partially bonded to each other.

[0427] Example 130: The article of any example herein, particularly the article of Example 112, wherein at least a portion of the second surface of the first material is disposed on the first surface of the first perforated material.

[0428] Example 131: The article of any example herein, particularly the article of Example 113, wherein at least a portion of the first surface of the first material is disposed on the second surface of the first perforated material.

[0429] Example 132: The article of any example herein, particularly the article of Example 115, wherein at least a portion of the second surface of the second material is disposed on the first surface of the second perforated material.

[0430] Example 133: The article of any example herein, particularly the article of Example 116, wherein at least a portion of the first surface of the second material is disposed on the second surface of the second perforated material.

[0431] Example 134: The article of any example herein, particularly the article of Example 118, wherein at least a portion of the second surface of the third material is disposed on the first surface of the third perforated material.

[0432] Example 135: The article of any example herein, particularly the article of Example 119, wherein at least a portion of the first surface of the third material is disposed on the second surface of the third perforated material.

[0433] Example 136: The article of any of the examples herein, particularly Examples 130-135, wherein at least a portion of the first auxiliary layer and the first perforated material are bonded to one another.

[0434] Example 137: The article of any of the examples herein, particularly Examples 132-136, wherein at least a portion of the second auxiliary layer and the second perforated material are bonded to one another.

[0435] Example 138: The article of any of the examples herein, particularly Examples 134-137, wherein at least a portion of the third auxiliary layer and the third perforated material are bonded to one another.

[0436] Example 139: A method of forming an implantable prosthetic valve, the method comprising: a) providing an annular frame having an inner surface and an outer surface, the frame having an inflow end and an outflow end and a central longitudinal axis extending from the inflow end to the outflow end; b) forming an inner skirt comprising a first material having a first surface and an opposite second surface, and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; c) forming an outer skirt comprising a second material having a first surface and an opposite second surface, and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; and d) attaching the inner skirt to at least a portion of the inner surface of the annular frame and attaching the outer skirt to at least a portion of the outer surface of the annular frame, wherein the implantable prosthetic valve is radially collapsed to a collapsed configuration and radially expandable to an expanded configuration.

[0437] Example 140: The method of any example herein, particularly the method of Example 139, wherein the steps of forming the inner skirt and attaching the inner skirt are performed simultaneously.

[0438] Example 141: The method of any example herein, particularly the method of Example 139, wherein the step of forming the inner skirt occurs before the attaching step.

[0439] Example 142: The method of any example herein, particularly Examples 139-141, wherein the steps of forming the outer skirt and attaching the outer skirt are performed simultaneously.

[0440] Example 143: The method of any example herein, particularly Examples 139-141, wherein the step of forming the outer skirt occurs before the attaching step.

[0441] Example 144: The method of any example herein, particularly Examples 139-142, wherein the step of attaching the inner skirt occurs before or after the step of attaching the outer skirt.

[0442] Example 145: The method of any example herein, particularly the method of Examples 139-144, further comprising the step of positioning a leaflet structure comprising a third material having a first surface and an opposing second surface, and comprising a plurality of fibers, wherein at least one fiber of the plurality of fibers comprises electrospun silk within at least a portion of an annular frame.

[0443] Example 146: The method of any example herein, particularly the method of Example 145, wherein the step of positioning the leaflet structure occurs before or after the step of forming the inner skirt and / or the outer skirt.

[0444] Example 147: The method of any example herein, particularly the method of Examples 145-146, wherein the first material, the second material, and the third material are the same or different.

[0445] Example 148: The method of any example herein, particularly the method of Example 140 or Examples 143-147, wherein the step of forming the inner skirt and simultaneously attaching the inner skirt to at least a portion of the inner surface of the annular frame includes forming a first material on at least a portion of the inner surface of the annular frame by directly electrospinning at least a portion of a plurality of fibers from a first solution comprising silk fibroin at a first predetermined concentration through at least one spinneret at a predetermined extrusion rate.

[0446] Example 149: The method of any example herein, particularly the method of Examples 141-147, wherein the step of forming the first material includes electrospinning at least a portion of a plurality of fibers from a first solution comprising silk fibroin at a first predetermined concentration through at least one spinneret at a first predetermined mandrel and at a predetermined extrusion rate.

[0447] Example 150: The method of any example herein, particularly the method of Example 149, wherein the attaching step includes the steps of: i) forming the first material to predetermined dimensions; and ii) attaching the first material to at least a portion of the inner surface of the annular frame.

[0448] Example 151: The method of any example herein, particularly the method of Example 142 or Examples 144-150, wherein the step of forming the outer skirt and simultaneously attaching the outer skirt to at least a portion of the outer surface of the annular frame includes forming a second material on at least a portion of the outer surface of the annular frame by directly electrospinning at least a portion of the plurality of fibers from a second solution containing silk fibroin at a second predetermined concentration through at least one spinneret at a predetermined extrusion rate.

[0449] Example 152: The method of any example herein, particularly the method of Examples 143-150, wherein the step of forming the second material includes electrospinning at least a portion of the plurality of fibers from a second solution containing silk fibroin at a second predetermined concentration through at least one spinneret at a predetermined extrusion rate on a second predetermined mandrel.

[0450] Example 153: The method of any example herein, particularly the method of Example 152, wherein the attaching step includes the steps of: i) forming the second material to predetermined dimensions; and ii) attaching the second material to at least a portion of the outer surface of the annular frame.

[0451] Example 154: The method of any example herein, particularly the methods of Examples 145-153, wherein the third material is formed by electrospinning a plurality of fibers from a third solution containing silk fibroin at a third predetermined concentration at a predetermined extrusion rate on a third predetermined mandrel.

[0452] Example 155: The method of any example herein, particularly the method of Example 154, wherein the third material is laser cut to form the leaflet structure.

[0453] Example 156: The method of any example herein, particularly Examples 139-154, wherein at least a portion of the annular frame is plasma treated prior to the step of forming the inner skirt and / or outer skirt.

[0454] Example 157: The method of any of the examples herein, particularly the methods of Examples 139 through 156, wherein an adhesive material is applied to at least a portion of the inner and / or outer surface of the annular frame prior to the step of attaching the inner skirt and / or outer skirt to at least a portion of the inner and / or outer surface of the annular frame, respectively.

[0455] Example 158: The method of any example herein, particularly Example 148 or Examples 151-157, wherein at least a portion of the inner surface of the annular frame is positioned a first predetermined distance from at least one extrusion spinneret during electrospinning of at least a portion of the plurality of fibers to form the first material.

[0456] Example 159: The method of any example herein, particularly Examples 149-151 or 154-157, wherein at least a portion of the outer surface of the annular frame is positioned a second predetermined distance from at least one extrusion spinneret during electrospinning of at least a portion of the plurality of fibers to form the second material.

[0457] Example 160: The method of any example herein, particularly the method of Example 148, Example 151, or Examples 156-159, wherein at least one extrusion spinneret is positioned outside the annular frame.

[0458] Example 161: The method of any example herein, particularly Example 148, Example 151, or Examples 156-160, wherein at least one extrusion spinneret is positioned within at least a portion of the interior space of the annular frame, the interior space being defined by the periphery of the inner surface of the annular frame.

[0459] Example 162: The method of any example herein, particularly the method of Example 161, wherein electrospinning is performed simultaneously from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and from at least one additional spinneret positioned outside the annular frame.

[0460] Example 163: The method of any example herein, particularly the method of Example 161, wherein electrospinning is first performed from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame, and then from at least one additional spinneret positioned outside the annular frame.

[0461] Example 164: The method of any example herein, particularly the method of Example 161, wherein electrospinning is first performed from at least one additional spinneret positioned outside the annular frame, and then from at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame.

[0462] Example 165: The method of any example herein, particularly the method of Example 163 or Example 164, wherein the electrospinning is carried out in a cyclic format.

[0463] Example 166: The method of any example herein, particularly Examples 161-165, wherein at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and at least one additional spinneret positioned outside the annular frame have the same or different extrusion rates.

[0464] Example 167: The method of any of the examples herein, particularly Examples 161 to 166, wherein at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and at least one additional spinneret positioned on the outside are each configured to electrospin multiple fibers from solutions having the same or different concentrations of silk fibroin.

[0465] Example 168: The method of any example herein, particularly the method of Examples 161 through 167, wherein at least one extrusion spinneret is positioned within at least a portion of the interior space of the annular frame at a third distance from the annular frame and is configured to be moved within the interior space of the annular frame.

[0466] Example 169: The method of any example herein, particularly the method of Example 168, wherein the third predetermined distance from the annular frame is adjustable.

[0467] Example 170: The method of any example herein, particularly Examples 161-167, wherein at least one additional spinneret positioned outside the annular frame is positioned a fourth predetermined distance from the annular frame.

[0468] Example 171: The method of any example herein, particularly the method of Example 169, wherein the fourth predetermined distance from the annular frame is adjustable.

[0469] Example 172: The method of any example herein, particularly the method of Example 170 or Example 171, wherein the first predetermined distance, the second predetermined distance, the third predetermined distance, and / or the fourth predetermined distance are the same or different.

[0470] Example 173: The method of any example herein, particularly Examples 162-172, wherein the plurality of fibers formed by at least one extrusion spinneret positioned within at least a portion of the interior space of the annular frame and at least one additional spinneret positioned outside the annular frame are consolidated.

[0471] Example 174: The method of any example herein, particularly the methods of Examples 154 through 173, wherein at least a portion of the third predetermined mandrel is positioned a third predetermined distance from the at least one extrusion spinneret during electrospinning of at least a portion of the plurality of fibers to form a third material.

[0472] Example 175: The method of any of the examples herein, particularly the methods of Examples 154 to 174, wherein during electrospinning of at least a portion of the plurality of fibers to form the first material, and / or the second material, and / or the third material, at least a portion of the inner surface of the annular frame, and / or at least a portion of the outer surface of the annular frame, and / or at least a portion of the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel, is positioned at a distance from at least one extrusion spinneret, and the distance is changed during electrospinning to form one or more layers within at least a portion of the first material, and / or the second material, and / or the third material.

[0473] Example 176: The method of any example herein, particularly Examples 148-175, wherein at least a portion of the annular frame is positioned on a rotating drum configured to rotate at a predetermined speed.

[0474] Example 177: The method of any example herein, particularly Examples 152-176, wherein the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel are configured to rotate or stationary.

[0475] Example 178: The method of any example herein, particularly the method of Example 176 or Example 177, wherein a first predetermined voltage is applied between the rotating drum and the at least one spinneret.

[0476] Example 179: The method of any example herein, particularly the method of Examples 152 through 178, wherein a second predetermined voltage is applied between the first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel and at least one spinneret.

[0477] Example 180: The method of any example herein, particularly the method of Examples 148-179, wherein at least one spinneret comprises a needle.

[0478] Example 181: The method of any example herein, particularly the method of Examples 148-180, wherein at least one spinneret is part of an assembly comprising a plurality of spinnerets.

[0479] Example 182: The method of any example herein, particularly the method of Example 181, wherein the assembly comprises a plurality of needleless spinnerets.

[0480] Example 183: The method of any of the examples herein, particularly Examples 145 to 182, wherein the plurality of fibers present in the first material, and / or the second material, and / or the third material include a first extension direction and a plurality of undulations.

[0481] Example 184: The method of any example herein, particularly the method of Example 183, wherein the first direction of extension comprises a circumferential direction, a radial direction, or a combination thereof.

[0482] Example 185: The method of any example herein, particularly the method of Example 183 or Example 184, wherein the plurality of undulations are present in the collapsed configuration of the implantable prosthetic valve.

[0483] Example 186: The method of any example herein, particularly the method of Examples 183-185, wherein the plurality of undulations are configured to straighten when the implantable prosthetic valve is in the expanded configuration.

[0484] Example 187: The method of any of the examples herein, particularly Examples 145 to 186, wherein at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material have a random orientation.

[0485] Example 188: The method of any of the examples herein, particularly Examples 145 to 187, wherein at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material have a predetermined side-by-side orientation.

[0486] Example 189: The plurality of fibers present in the first material, and / or the second material, and / or the third material are Absorbency material, Non-absorbable The method of any of the examples herein, particularly the methods of Examples 145 through 188, further comprising:

[0487] Example 190: The method of any example herein, particularly the method of Examples 145-189, wherein the plurality of fibers present in the first material, and / or the second material, and / or the third material further comprise thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(esterurethane)urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0488] Example 191: A plurality of fibers are mixed at a predetermined concentration. Absorbency material, Non-absorbable The method of any of the examples herein, particularly the methods of Examples 145 through 190, wherein the material is deposited by electrospinning through at least one spinneret from a first solution, and / or a second solution, and / or a third solution further comprising the material, or a combination thereof.

[0489] Example 192: The method of any example herein, particularly the method of Example 190, wherein the plurality of fibers are disposed by electrospinning through at least one spinneret from a first solution, and / or a second solution, and / or a third solution, further comprising a predetermined concentration of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof, at a predetermined extrusion rate.

[0490] Example 193: The method of any example herein, particularly the methods of Examples 140 to 192, wherein at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material comprise bicomponent fibers.

[0491] Example 194: The method of any example herein, particularly the method of Example 193, wherein the bicomponent fiber comprises a side-by-side configuration, a sheath-core configuration, a trilobal configuration, an islands-in-the-sea configuration, a split-pie configuration, or any combination thereof.

[0492] Example 195: The method of any example herein, particularly the method of Example 194, wherein the bicomponent fiber has a sheath-core configuration.

[0493] Example 196: The sheath and core of a composite fiber are Absorbency material, Non-absorbable The method of any example herein, particularly the method of Example 195, including the materials, or combinations thereof.

[0494] Example 197: The sheath of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof, and the core of the bicomponent fiber comprises one or more of silk, thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof. The method of any example herein, particularly the method of Example 195, comprising one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polyolefin such as polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0495] Example 198: The method of any example herein, particularly the method of Example 195 or Example 197, wherein the sheath of the bicomponent fiber comprises silk and the core of the bicomponent fiber comprises one or more of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof.

[0496] Example 199: Composite fibers are deposited by electrospinning through at least two concentric spinnerets, the outer spinneret configured to extrude sheath fibers from a fourth solution containing a fourth predetermined concentration of silk fibroin, and the inner spinneret configured to extrude sheath fibers from a fourth solution containing a fourth predetermined concentration of silk fibroin. Absorbency material, Non-absorbable The method of any example herein, particularly the method of Example 198, configured to extrude the core fiber from a fifth solution comprising the material, or a combination thereof.

[0497] Example 200: The method of any example herein, particularly the method of Example 198, wherein the composite fiber is deposited by electrospinning through at least two concentric spinnerets, the outer spinneret configured to extrude sheath fibers from a fourth solution comprising a fourth predetermined concentration of silk fibroin, and the inner spinneret configured to extrude core fibers from a fifth solution comprising a predetermined concentration of thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyester (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), polyamide (nylon), polypropylene, polyetheretherketone (PEEK), polyglycolic acid (PGA), poly(ester urethane) urea, polylactic acid (PLA), polycaprolactone (PCL), polylactic-glycolic acid (PLGA), or any combination thereof, at a predetermined extrusion rate.

[0498] Example 201: The method of any example herein, particularly Examples 145 to 200, wherein the plurality of fibers present in the first material, and / or the second material, and / or the third material have an average diameter of about 3 nm to about 15,000 nm.

[0499] Example 202: The method of any example herein, particularly Examples 145-201, wherein at least a portion of the first material, and / or the second material, and / or the third material exhibits porosity.

[0500] Example 203: The method of any example herein, particularly the method of Example 202, wherein at least a portion of the first material, and / or the second material, and / or the third material has an average pore size of about 100 nm to about 100 μm.

[0501] Example 204: The method of any example herein, particularly the methods of Examples 145 through 203, wherein the first material, and / or the second material, and / or the third material comprise multiple layers, each of the multiple layers comprising electrospun silk, and each of the multiple layers being disposed on top of one another.

[0502] Example 205: The method of any example herein, particularly the method of Example 204, wherein at least a first portion of the plurality of layers has a surface area that is substantially less than a surface area of ​​a second portion of the surface area of ​​the plurality of layers.

[0503] Example 206: The method of any example herein, particularly Examples 145 to 205, wherein the first material, and / or the second material, and / or the third material exhibits a tensile strength of greater than 0 MPa to about 20 MPa.

[0504] Example 207: The method of any example herein, particularly Examples 145 to 206, wherein the first material, and / or the second material, and / or the third material exhibits an elongation at break of greater than 0% to about 600%.

[0505] Example 208: The method of any example herein, particularly Examples 145 through 207, wherein the first material, and / or the second material, and / or the third material exhibits a water contact angle of about 0° to about 180°.

[0506] Example 209: The method of any example herein, particularly the methods of Examples 145-208, wherein at least a portion of the first material, and / or the second material, and / or the third material is biodegradable.

[0507] Example 210: The method of any example herein, particularly the methods of Examples 145-209, wherein at least a portion of the first material, and / or the second material, and / or the third material is bioabsorbable.

[0508] Example 211: The method of any example herein, particularly the method of Examples 145-210, wherein at least a portion of the first material, and / or the second material, and / or the third material is degradable.

[0509] Example 212: The method of any of the examples herein, particularly Examples 139 to 211, wherein at least a portion of the first material, and / or the second material, and / or the third material is configured to be a scaffold material.

[0510] Example 213: The method of any example herein, particularly the methods of Examples 154 through 212, wherein at least a portion of the plurality of fibers present in the first material, and / or the second material, and / or the third material are plasma treated after electrospinning.

[0511] Example 214: The method of any of the examples herein, particularly the methods of Examples 150 to 213, wherein at least a portion of the formed first material is disposed on a first porous material having a first surface and an opposite second surface prior to the attaching step, and the first material is disposed on the first surface and / or the second surface of the first porous material.

[0512] Example 215: The method of any example herein, particularly the method of Example 214, wherein the attaching step includes bonding a first surface of the first perforated material to at least a portion of the annular frame.

[0513] Example 216: The method of any of the examples herein, particularly the methods of Examples 152 to 215, wherein at least a portion of the formed second material is disposed on a second porous material having a first surface and an opposite second surface prior to the attaching step, and the second material is disposed on the first surface and / or the second surface of the second porous material.

[0514] Example 217: The method of any example herein, particularly the method of Example 216, wherein the attaching step includes bonding a first surface of the second perforated material to at least a portion of the annular frame.

[0515] Example 218: The method of any of the examples herein, particularly the methods of Examples 154 to 217, wherein at least a portion of the leaflet structure is disposed in a third porous material having a first surface and an opposite second surface, and the third material is disposed on the first surface and / or the second surface of the third porous material.

[0516] Example 219: The method of any example herein, particularly the method of Example 218, wherein the first perforated material, the second perforated material, and / or the third perforated material are the same or different.

[0517] Example 220: The method of any example herein, particularly the method of Examples 150-219, including disposing a first auxiliary layer on at least a portion of the first surface of the first material.

[0518] Example 221: The method of any example herein, particularly the method of Examples 150-220, including disposing a first auxiliary layer on at least a portion of the second surface of the first material.

[0519] Example 222: The method of any example herein, particularly the method of Example 221, wherein the first auxiliary layer present on the second surface of the first material is the same as or different from the first auxiliary layer present on the first surface of the first material.

[0520] Example 223: The method of any example herein, particularly the method of Examples 153-222, including disposing a second auxiliary layer on at least a portion of the first surface of the second material.

[0521] Example 224: The method of any example herein, particularly the method of Examples 153-223, including disposing a second auxiliary layer on at least a portion of the second surface of the second material.

[0522] Example 225: The method of any example herein, particularly the method of Example 224, wherein the second auxiliary layer present on the second surface of the second material is the same as or different from the second auxiliary layer present on the first surface of the second material.

[0523] Example 226: The method of any example herein, particularly the method of Examples 154-225, including disposing a third auxiliary layer on at least a portion of the first surface of the third material.

[0524] Example 227: The method of any example herein, particularly the method of Examples 154-225, including disposing a third auxiliary layer on at least a portion of the second surface of the third material.

[0525] Example 228: The method of any example herein, particularly the method of Example 227, wherein the third auxiliary layer present on the second surface of the third material is the same as or different from the third auxiliary layer present on the first surface of the third material.

[0526] Example 229: The method of any example herein, particularly the methods of Examples 227-228, wherein each of the first sublayer, second sublayer, or third sublayer is the same or different.

[0527] Example 230: The first perforated material, the second perforated material, and / or the third perforated material comprise a porous fabric or membrane, and the porous fabric or membrane comprises: Absorbency material, Non-absorbable The method of any of the examples herein, particularly the methods of Examples 219-229, including the materials, or combinations thereof.

[0528] Example 231: The method of any example herein, particularly the method of Examples 219-230, wherein the first porous material, the second porous material, and / or the third porous material comprises a porous braid or membrane, and the porous braid or membrane comprises one or more biocompatible polymers selected from polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA), or a combination thereof, or a natural / regenerated fiber selected from cotton, silk, hemp, cellulose acetate, collagen, or a combination thereof.

[0529] Example 232: The method of any of the examples herein, particularly the methods of Examples 227-231, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are configured to impart hydrophobic or hydrophilic properties, elasticity, mechanical recovery, adhesive properties, tissue ingrowth inhibition, or any combination thereof, to at least a portion of the first material, the second material, and / or the third material.

[0530] Example 233: The first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer are: Absorbency material, Non-absorbable The method of any example herein, particularly the method of Example 232, including any of the materials, or combinations thereof.

[0531] Example 234: The method of any example herein, particularly the method of Example 232 or Example 233, wherein the first auxiliary layer, the second auxiliary layer, and / or the third auxiliary layer comprises one or more thermoplastic polyurethane (TPU), polyurethane (PU), implantable elastane polymer, or polyethylene, polypropylene, polymethyl methacrylate (PMMA), polystyrene (PS), polytetrafluoroethylene (PTFE), polyamide, polyethylene terephthalate (PET), polyethersulfone, polylactic-glycolic acid (PLGA).

[0532] Example 235: The method of any example herein, particularly the method of Examples 150 through 234, including a step of disposing the first material between two layers of the first porous material, wherein the two layers of the first porous material are at least partially bonded to one another.

[0533] Example 236: The method of any example herein, particularly the method of Examples 151 through 235, including a step of disposing the second material between two layers of the second porous material, wherein the two layers of the second porous material are at least partially bonded to one another.

[0534] Example 237: The method of any example herein, particularly the method of Examples 154 through 236, including a step of disposing a third material between two layers of a third porous material, wherein the two layers of the third porous material are at least partially bonded to one another.

[0535] Example 238: The method of any example herein, particularly the method of Example 220, wherein at least a portion of the second surface of the first material is disposed on the first surface of the first porous material.

[0536] Example 239: The method of any example herein, particularly the method of Example 221, wherein at least a portion of the first surface of the first material is disposed on the second surface of the first porous material.

[0537] Example 240: The method of any example herein, particularly the method of Example 223, wherein at least a portion of the second surface of the second material is disposed on the first surface of the second porous material.

[0538] Example 241: The method of any example herein, particularly the method of Example 224, wherein at least a portion of the first surface of the second material is disposed on the second surface of the second porous material.

[0539] Example 242: The method of any example herein, particularly the method of Example 226, wherein at least a portion of the second surface of the third material is disposed on the first surface of the third porous material.

[0540] Example 243: The method of any example herein, particularly the method of Example 231, wherein at least a portion of the first surface of the third material is disposed on the second surface of the third porous material.

[0541] Example 244: The method of any example herein, particularly Examples 238-243, wherein at least a portion of the first auxiliary layer and at least a portion of the first porous material are bonded to one another.

[0542] Example 245: The method of any example herein, particularly Examples 240-244, wherein at least a portion of the second auxiliary layer and at least a portion of the second perforated material are bonded to one another.

[0543] Example 246: The method of any example herein, particularly Examples 242-245, wherein at least a portion of the third auxiliary layer and at least a portion of the third porous material are bonded to one another.

[0544] While several aspects of the present disclosure have been disclosed in the foregoing specification, it will be understood by those skilled in the art that many variations and other aspects of the present disclosure will come to mind to those to whom this disclosure pertains having the benefit of the teachings presented in the foregoing description and the associated drawings. It is therefore understood that the present disclosure is not limited to the specific aspects disclosed hereinabove, and that many variations and other aspects are intended to be included within the scope of the appended claims. Furthermore, although specific terms have been employed in this specification and in the claims that follow, they are used in a generic and descriptive sense only and not for the purpose of limiting the present disclosure and the claims that follow as set forth. Applicant therefore claims all of Applicant's disclosures that come within the scope and spirit of these claims. [Explanation of symbols]

[0545] 5 Control circuit 10 Artificial valve 11 Motor, collection assembly 12 Linear motor 13th axis, vertical axis 14 Collection spindle, mandrel / holding tool spindle 16 Inflow section, inflow end section 18 Outflow section, Outflow end section 22 Valve leaflets 24 Longitudinal Axis 26 Lattice strut 28 Top 30 outer skirt 32, 34 Opening 36 Fasteners 38 Main body part 70 Retainer component, collection assembly, collection device, retainer, collector 71 Collection Assembly 73 Stents, Medical Implant Device Components, Collection Assemblies 75 rotating mandrel 76 Collection Assembly 79 Collector assembly, collection assembly 80 Vessels, stacking assemblies, rotating structures 81 Route / Plane 83 Stacking rotation axis, container rotation axis 85 Rotary Jet Spinning Materials, Polymer Fibers 86 Rotation motor, stacking assembly 100 Central Longitudinal Axis 110 Stent Frame 118 Columns and struts 120 Lower Strut 122, 124 Upper struts 126 Parietal structure, parietal area 130 strut 132 Intersection 140 Valve leaflet structure 200, 200a devices 202 frames 204 Outer Skirt 206 Swell 300 Devices, valves, valve implant devices 301 Inner Skirt 310 Stent Frame 320 outer skirt 322 Fabric piece 328 Edge 364 Valve leaflet structure 380 Inflow end 382 Outlet end 500 Electrospinning System 502 Syringe 504 Electrospinning Solution 506 Syringe Pump 508 High Voltage 512 Rotating Drum 600 System 602 Electrospun Materials 604 Stent Frame 606 Sources of Electrospun Materials 608 Collector 610 Control device 630 High voltage output supply unit 632 Electric wire 634 base 636 Rotary Tools 638 First Edge 640 Rotating holder 642 Second End 648 Mandrel 700 Electrospinning System 702 Solution container 704 Needle spinneret 706 Mandrel 709 High Voltage 802 Rotating spinneret, roller type 804 Rotating spinneret, conical 806 Rotating spinneret, beaded chain 808 Rotating spinneret, disc-shaped 810 Rotating spinneret, spiral 812 Rotary spinneret, cylindrical 814 Rotating spinneret, spherical 820 Spinning Solution 830 DC motor 840 High voltage output supply unit 902 Container 904 Cylindrical spinneret 906 Bowl-shaped spinneret 908 Plate-shaped spinneret 910 Conical Wire Spinneret 920 Electrospinning Solution 922 Solution Foam 924 Solution layer 930 Solution container 940 High Voltage 950 Magnetic Fluid 955 Magnet 960 High-pressure nitrogen gas 1000 systems 1100 equipment 1102 Circular Frame 1104 Holder 1106, 1108 Extrusion spinneret 1200 Stents, Frames 1300 Material Composition 1302 Auxiliary layer 1304 Electrospun Fibers 1306, 1306a, 1306b Porous materials θ angle

Claims

1. 1. A method of forming an implantable prosthetic valve, comprising: a) providing an annular frame having an inner surface and an outer surface, said frame having an inlet end, an outlet end, and a central longitudinal axis extending from said inlet end to said outlet end; b) forming an inner skirt comprising a first material having a first surface and an opposing second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; c) forming an outer skirt comprising a second material having a first surface and an opposite second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk; d) attaching the inner skirt to at least a portion of the inner surface of the annular frame, and attaching the outer skirt to at least a portion of the outer surface of the annular frame; Including, the implantable prosthetic valve is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration; The method wherein at least a portion of the inner skirt is attached to the annular frame by direct electrospinning of the plurality of fibers onto at least a portion of the inner surface of the annular frame.

2. The method of claim 1 , wherein the steps of forming the inner skirt and attaching the inner skirt are performed simultaneously.

3. The method of claim 1 or 2, wherein the steps of forming the outer skirt and attaching the outer skirt are performed simultaneously.

4. 4. The method of claim 3, wherein the step of simultaneously forming the outer skirt and attaching the outer skirt to the at least a portion of the outer surface of the annular frame comprises forming the second material on the at least a portion of the outer surface of the annular frame by directly electrospinning at least a portion of the plurality of fibers from a second solution comprising silk fibroin at a second predetermined concentration through at least one spinneret at a predetermined extrusion rate.

5. The method of claim 1 or 2, wherein the step of forming the outer skirt occurs before the step of attaching.

6. 6. The method of any one of claims 1 to 5, further comprising positioning a leaflet structure comprising a third material having a first surface and an opposing second surface and comprising a plurality of fibers, at least one fiber of the plurality of fibers comprising electrospun silk within at least a portion of the annular frame.

7. 7. The method of claim 2, wherein the step of simultaneously forming the inner skirt and attaching the inner skirt to at least a portion of the inner surface of the annular frame comprises forming the first material on at least a portion of the inner surface of the annular frame by directly electrospinning at least a portion of the plurality of fibers from a first solution comprising silk fibroin at a first predetermined concentration through at least one spinneret at a predetermined extrusion rate.

8. 7. The method of claim 6, wherein forming the second material comprises electrospinning at least a portion of the plurality of fibers through at least one spinneret from a second solution comprising silk fibroin at a second predetermined concentration on a second predetermined mandrel at a predetermined extrusion rate.

9. 9. The method of claim 8, wherein the attaching step comprises: i) forming the second material to a predetermined dimension; and ii) attaching the second material to the at least a portion of the outer surface of the annular frame.

10. 10. The method of claim 8 or 9, wherein the third material is formed by electrospinning the plurality of fibers on a third predetermined mandrel from a third solution comprising silk fibroin at a third predetermined concentration at a predetermined extrusion rate.

11. 11. The method of any one of claims 7 to 10, wherein the electrospinning is performed in a cyclic manner.

12. 11. The method of claim 10, wherein during the electrospinning of at least a portion of the plurality of fibers to form the first material, the second material, and / or the third material, the at least a portion of the inner surface of the annular frame and / or the at least a portion of the outer surface of the annular frame, and / or the at least a portion of a first predetermined mandrel, the second predetermined mandrel, and / or the third predetermined mandrel are positioned at a distance from the at least one spinneret, and the distance is varied during the electrospinning to form one or more layers within at least a portion of the first material, the second material, and / or the third material.

13. 13. The method of any one of claims 7 to 12, wherein the at least one spinneret comprises a needle.

14. 13. The method of any one of claims 7 to 12, wherein the at least one spinneret is part of an assembly comprising multiple spinnerets.

15. The method of claim 14 , wherein the assembly comprises a plurality of needleless spinnerets.

16. 16. The method of claim 5, wherein at least a portion of the formed second material is disposed on a second perforated material having a first surface and an opposite second surface before the attaching step, and the second material is disposed on the first surface and / or the second surface of the second perforated material.

17. 13. The method of any one of claims 6, 8-10 and 12, wherein at least a portion of the leaflet structure is disposed in a third perforated material having a first surface and an opposite second surface, the third material being disposed on the first surface and / or the second surface of the third perforated material.

18. 18. The method according to claim 5, further comprising disposing a second auxiliary layer on at least a portion of the first surface of the second material and / or on at least a portion of the second surface of the second material.

19. 18. The method of claim 6, comprising disposing a third auxiliary layer on at least a portion of the first surface of the third material and / or on at least a portion of the second surface of the third material.

20. 17. The method of claim 16, comprising disposing the second material between two layers of the second perforated material, the two layers of the second perforated material being at least partially bonded to one another.

21. 20. The method of claim 17, comprising disposing the third material between two layers of the third perforated material, the two layers of the third perforated material being at least partially bonded to one another.

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