WO2023206710A1

WO2023206710A1 - Valve stent and valve prosthesis

Info

Publication number: WO2023206710A1
Application number: PCT/CN2022/096676
Authority: WO
Inventors: 张婧; 刘世红; 邱尧; 陈国明
Original assignee: 上海微创心通医疗科技有限公司
Priority date: 2022-04-24
Filing date: 2022-06-01
Publication date: 2023-11-02
Also published as: CN218420135U

Abstract

A valve stent and a valve prosthesis. The valve stent comprises: a stent body (10) and a barb structure (20). The stent body (10), in its own circumferential direction, is at least divided into an anterior leaflet region (11), a posterior leaflet region (12), and valve leaflet connection regions (13, 14). The barb structure (20) comprises at least two rows of barbs (21). The barbs (21) are arranged in the circumferential direction of the stent body (10). The density of the barbs (21) arranged in the valve leaflet connection regions (13, 14) is less than the density of the barbs (21) in the anterior leaflet region (11) and is not greater than the density of the barbs (21) in the posterior leaflet region (12). In this way, the barbs (21) can conform to the physiologically anatomical region of native valve leaflets, so that the degree of damage to the native valve leaflets and surrounding tissues thereof caused by the barbs (21) is reduced, which solves the problem of serious damage to the native valve leaflets and the surrounding tissues thereof caused by the barbs (21) after the valve stent is implanted.

Description

Valve stents and valve prostheses

Technical field

The present application relates to the technical field of medical devices, and in particular to a valve stent and a valve prosthesis.

Background technique

With the development of social economy and the aging of the population, senile valvular disease and valvular lesions caused by coronary heart disease and myocardial infarction are becoming more and more common. Research shows that more than 13.3% of people over the age of 75 suffer from varying degrees of heart valve disease. Heart valve disease has gradually become one of the important causes threatening human health. Mitral valve, tricuspid valve, and aortic valve diseases are relatively common clinical heart valve diseases. Taking the mitral valve as an example, the human heart is divided into four chambers: left atrium, left ventricle, right atrium, and right ventricle. The two atria are connected to the two ventricles respectively, and the two ventricles are connected to the two aorta. The mitral valve grows between the left atrium and the left ventricle and is composed of leaflets, annulus, chordae tendineae, and papillary muscles. It functions as a one-way valve to ensure that blood flow is only allowed to move in one direction from the left atrium to the left ventricle. . Mitral regurgitation, one of the most common mitral valve diseases, occurs when the mitral valve fails to close properly during the ventricular systole phase and blood flows backward from the left ventricle into the left atrium. The use of mitral valve replacement devices is one of the common treatments. The mitral valve replacement device is an implantable prosthetic device, which consists of three parts: artificial valve leaflets, skirt, and stent. The function of the stent is to fix the artificial valve leaflets in the position of the native mitral valve leaflets, so that the artificial valve leaflets can work normally and fix the native mitral valve leaflets to ensure normal blood flow in the left heart.

However, in existing valve prostheses, there are many ways for the valve stent of the valve prosthesis to fix the native valve leaflets, such as using barbs to fix the valve stent and the native valve leaflets. However, the barbs are usually designed to be evenly distributed and do not conform to the heart. Physiological structure of native tissue. At the same time, too many barbs will cause damage to the native valve leaflets and surrounding tissues, such as the aortic valve, myocardium, chordae tendineae, etc., which is detrimental to the treatment effect and may even cause complications.

Therefore, it is an urgent problem to develop a valve stent and valve prosthesis that can reduce the damage caused by barbs to the native valve leaflets and surrounding tissues.

Contents of the invention

The purpose of this application is to provide a valve stent and a valve prosthesis to solve the current problem in the valve stent that the barbs seriously damage the native valve leaflets and surrounding tissues.

In order to solve the above technical problems, the present application provides a valve stent, which includes a stent body and a barb structure; the stent body is divided along its own circumferential direction into at least an anterior leaflet region, a posterior leaflet region, and a valve leaflet connection region; The barb structure includes at least two rows of barbs, each row of barbs is arranged along the circumference of the stent body, and the density of barbs provided in the leaflet connection area is smaller than the density of barbs in the front leaflet area. , and not greater than the density of barbs in the posterior leaf area.

Optionally, the rear leaf area includes a rear leaf area, a middle area of the rear leaf and a front area of the rear leaf, and the density of barbs provided in the middle area of the rear leaf is smaller than the rear area and/or the rear leaf. or the density of barbs in the anterior region of the posterior lobe.

Optionally, the leaflet connection area at least includes a front connection area and a rear connection area, and at least one of the front connection area, the rear connection area and the middle area of the rear leaflet. The operator does not set any barbs.

Optionally, the leaflet connection area at least includes a front connection area and a rear connection area, and the front connection area and/or the rear connection area are along the circumferential direction of the stent body. The angle distribution is greater than 0° and less than or equal to 90°, and the angle distribution of the front leaf region along the circumferential direction of the stent body is 60° to 180°.

Optionally, the rear leaf area includes a rear leaf area, a middle area of the rear leaf, and a front area of the rear leaf, and the angle distribution of the middle area of the rear leaf along the circumferential direction of the stent body is 0° to 90°. , the angle distribution of the rear area of the rear leaf and/or the front area of the rear leaf along the circumferential direction of the stent body is 60° to 150°

Optionally, in any two rows of barbs among the at least two rows of barbs, the number of barbs in the row closer to the inflow channel of the stent body is smaller than that in the other row.

Optionally, the barb structure includes two rows of barbs. The two rows of barbs are a first row of barbs and a second row of barbs. The first row of barbs is smaller than the second row of barbs. The barbs are closer to the inflow channel, the first row of barbs are used to snap into the middle part of the native valve leaflet, and the second row of barbs are used to snap into the edge part of the native valve leaflet.

Optionally, the number of barbs in the first row is smaller than the number of barbs in the second row.

Optionally, the barb structure is integrally formed with the stent body.

In order to solve the above technical problems, the present application also provides a valve prosthesis, which includes the valve stent as described above.

In the valve stent and valve prosthesis provided by this application, the valve stent includes a stent body and a barb structure; the stent body is divided along its own circumferential direction into at least an anterior leaflet region, a posterior leaflet region, and a valve leaflet. Connection area; the barb structure includes at least two rows of barbs, the barbs are arranged along the circumference of the stent body, and the density of the barbs provided in the leaflet connection area is smaller than the barbs in the front leaflet area. The density of spines is not greater than the density of barbs in the posterior leaf area. In this way, the barbs can be made to conform to the physiological anatomical area of the native valve leaflets, so that the degree of damage caused by the barbs to the native valve leaflets and their surrounding tissues is reduced, and the problem of the damage caused by the barbs to the native valve leaflets and their surrounding tissues after the valve stent is implanted is solved. Serious damage problem.

Description of the drawings

Those of ordinary skill in the art will understand that the drawings are provided for a better understanding of the present application and do not constitute any limitation on the scope of the present application. in:

Figure 1 is a schematic diagram of the division of each region of the valve stent provided by an embodiment of the present application.

Figure 2 is a schematic diagram of a valve stent provided by an embodiment of the present application.

Figure 3 is a schematic diagram of the valve stent provided by an embodiment of the present application from another angle.

Figure 4 is a top view of a valve stent provided by an embodiment of the present application.

In the attached picture:

A-inflow tract, B-outflow tract;

10-stent body, 11-front leaflet area, 12-posterior leaflet area, 121-posterior leaflet rear area, 122-posterior leaflet middle area, 123-posterior leaflet front area, 13-valve leaflet anterior connection area, 14- Postleaf connection area;

20-Barb structure, 21-Barb, 211-First row of barbs, 212-Second row of barbs.

Detailed ways

In order to make the purpose, advantages and features of the present application clearer, the present application will be further described in detail below in conjunction with the accompanying drawings and specific embodiments. It should be noted that the accompanying drawings are in a very simplified form and are not drawn to scale, and are only used to conveniently and clearly assist the purpose of explaining the embodiments of the present application. In addition, the structures shown in the drawings are often part of the actual structure. In particular, each drawing needs to display different emphasis, and sometimes uses different proportions.

As used in this specification, the singular forms "a," "an," and "the" include plural referents unless the content clearly dictates otherwise. As used in this specification, the term "or" is generally used in its sense including "and/or" unless the content clearly dictates otherwise. The term "several" is generally used in the sense of including "at least one", and the term "at least two" is generally used in the sense of including "two or more". In addition, the term "first ”, “second” and “third” are used for descriptive purposes only and cannot be understood as indicating or implying relative importance or implicitly indicating the quantity of indicated technical features. Therefore, the features defined as "first", "second" and "third" may explicitly or implicitly include one or at least two of these features, and the terms "mounted", "connected" and "connected" shall be Broadly understood, for example, it can be a fixed connection, a detachable connection, or an integral body; it can be a direct connection or an indirect connection through an intermediate medium; it can be an internal connection between two elements or an interaction between two elements. . In addition, as used in this application, one element is disposed on another element, which usually only means that there is a connection, coupling, matching or transmission relationship between the two elements, and the relationship between the two elements may be direct or indirect through an intermediate element. connection, coupling, cooperation or transmission, and cannot be understood as indicating or implying the spatial positional relationship between the two elements, that is, one element can be in any position such as inside, outside, above, below or to one side of the other element, unless the content Also clearly stated. For those of ordinary skill in the art, the specific meanings of the above terms in this application can be understood according to specific circumstances. Additionally, in the following description, numerous specific details are given in order to provide a thorough understanding of the present application. However, it will be apparent to one skilled in the art that the present application may be practiced without one or more of these details. In other examples, some technical features that are well known in the art are not described in order to avoid confusion with the present application.

Embodiments of the present application provide a valve stent and a valve prosthesis. The valve stent includes a stent body and a barb structure; the stent body is divided along its own circumferential direction into at least an anterior leaflet region, a posterior leaflet region, and a valve leaflet. Connection area; the barb structure includes at least two rows of barbs, the barbs are arranged along the circumference of the stent body, and the density of the barbs provided in the leaflet connection area is smaller than the barbs in the front leaflet area. The density of spines is not greater than the density of barbs in the posterior leaf area. In this way, the barbs can be made to conform to the physiological anatomical area of the native valve leaflets, so that the degree of damage caused by the barbs to the native valve leaflets and their surrounding tissues is reduced, and the problem of the damage caused by the barbs to the native valve leaflets and their surrounding tissues after the valve stent is implanted is solved. Serious damage problem.

Description will be made below with reference to the drawings.

Please refer to Figures 1 to 4. This embodiment provides a valve stent. The valve stent can be applied to native valve leaflets such as mitral valve, tricuspid valve and aorta. The valve stent includes: a stent body 10 and a barbed structure 20 .

The stent body 10 is divided along its circumferential direction into at least an anterior leaflet area 11, a posterior leaflet area 12 and a leaflet connection area. Preferably, according to the circumferential division of the stent body 10 , the leaflet connection area at least includes a leaflet front connection area 13 and a leaflet rear connection area 14 . It should be understood that the area division of the stent body 10 is set according to the type of implanted valve leaflets. For example, in this embodiment, the valve stent needs to be implanted in the mitral valve, and the region of the stent body 10 is divided according to the mitral valve, that is, the stent body 10 is divided into anterior leaflets along its own circumferential direction. Area 11, posterior lobe area 12. Among them, the specific division of the leaflet connection area is also divided according to the type of the leaflet. For example, in this embodiment, the mitral valve has an anterolateral triangle and a posterolateral triangle, and the leaflet connection area has an anterior connection area of the leaflet respectively. Region 13 and leaflet posterior connection region 14 are used to match the anterolateral triangle and posterolateral triangle of the mitral valve. In other embodiments, when the valve stent needs to be implanted into the tricuspid valve, the region of the stent body 10 is divided according to the region of the tricuspid valve, that is, the stent body 10 is divided into anterior leaflet regions along its own circumference. , posterior lobe area, septal lobe area. Among them, the specific division of the leaflet connection area is also divided according to the type of the leaflet. For example, the valve leaflet connection area includes three areas, namely the connection area between the anterior leaflet area and the posterior leaflet area, and the connection area between the anterior leaflet area and the septal leaflet area. area, the connecting area between the posterior lobe area and the septal lobe area. These three areas respectively correspond to the connection parts between the three leaflets of the tricuspid valve, so that the stent body 10 and the tricuspid valve have a high degree of matching.

The barb structure 20 includes at least two rows of barbs 21. The barbs 21 are arranged along the circumference of the stent body 10 so that the barbs 21 can penetrate into the native valve leaflets and thereby fix the stent body 10 to the native valve leaflets. Leaf position. It should be understood that the distribution position of the barbs 21 corresponds to the native valve leaflets of the heart, and the division of the regions is based on anatomical positions. The density of the barbs 21 provided in the leaflet connection area, for example, the barbs 21 provided in the leaflet front connection area 13 and the valve leaflet rear connection area 14 is smaller than the barbs in the front leaflet area 11 21, and is no greater than the density of barbs 21 in the posterior leaf area 12. Such arrangement can make the barb 21 conform to the physiological anatomical area of the native valve leaflet, so that the degree of damage to the connecting area of the anterior and posterior leaflets of the native valve leaflet by the barb 21 is smaller than the degree of damage to the anterior leaflet and posterior leaflet of the native valve leaflet by the barb 21. , it can also reduce the damage of the barbs 21 to the surrounding tissue, thereby ensuring the normal opening and closing of the artificial valve leaflets, and controlling the original valve leaflets without affecting the blood flow, effectively reducing the damage of the barbs 21 to the heart tissue, that is, using more Fewer barbs 21 achieve better therapeutic effect. Moreover, the density of the barbs 21 in the connecting area of the anterior and posterior leaflets is relatively reduced, so that the number of barbs 21 is relatively reduced, which is beneficial to reducing the volume of the valve stent in the delivery tube, thereby reducing the size of the delivery tube and reducing the need for valve stent implantation Damage to blood vessels, atrial septum or myocardium during the process.

This article takes the mitral valve as an example for description. That is, in this embodiment, the leaflets described below can all represent the mitral valve leaflets.

Preferably, as shown in Figure 1, the rear leaf area 12 includes a rear leaf rear area 121, a rear leaf middle area 122 and a rear leaf front area 123, and the barbs 21 are provided in the rear leaf middle area 122. The density is smaller than the density of the barbs 21 in the posterior region 121 and/or the anterior region 123 of the posterior leaflet, which can reduce the impact of the barbs 21 in the middle region 122 of the posterior leaflet on the posterior leaflet and the native valve leaflet. The damage to the posterior atrial wall further reduces the damage of the barb 21 to the heart tissue. Preferably, the density of the barbs 21 in the middle region 122 of the posterior leaf is smaller than the density of the barbs 21 in the posterior region 121 and the front region 123 of the posterior leaf.

Furthermore, the density of the barbs 21 provided in the front connection area 13 of the leaflets, the rear connection area 14 of the leaflets and/or the middle area 122 of the posterior leaflets is smaller than that in the front leaflet area 11 and the rear side of the posterior leaflets. The density of barbs 21 in the region 121 and the anterior region 123 of the posterior leaflet can thereby reduce the damage caused by the barbs 21 to the leaflet front connection region 13, the leaflet posterior connection region 14 and/or the posterior leaflet middle region 122 . Furthermore, the leaflet connection area at least includes a leaflet front connection area 13 and a leaflet rear connection area 14, the leaflet front connection area 13, the leaflet rear connection area 14 and the middle area of the rear leaflet. At least one of 122 does not have the barbed structure, so that when the valve stent is implanted at the native valve leaflet position, the tissues in these areas will not be damaged. Specifically, barbs 21 are not provided in the leaflet front connection area 13 and the valve leaflet rear connection area 14, which can reduce the damage of the barbs 21 to the myocardium. No barbs 21 are provided in the middle region 122 of the posterior leaflet, which can reduce the damage caused by the barbs 21 to the posterior leaflet and the posterior atrial wall of the native valve leaflet.

Preferably, as shown in FIG. 1 , the leaflet connection area at least includes a leaflet front connection area 13 and a leaflet rear connection area 14 , and the leaflet front connection area 13 and/or the leaflet rear connection area 14 The angular distribution along the circumferential direction of the stent body 10 is greater than 0° and less than or equal to 90°, and the angular distribution of the anterior leaf region 11 along the circumferential direction of the stent body 10 is 60° to 180°. For example, the angular distribution of the leaflet front connection area 13 and the leaflet rear connection area 14 along the circumferential direction of the stent body 10 is 30° respectively. The angle distribution of the front leaf area 11 along the circumferential direction of the stent body 10 is 110°. The angle distribution of the posterior leaf area 12 along the circumferential direction of the stent body 10 is 190°. Of course, the angle distribution of each area can also be set according to the actual situation, and this article will not go into details here. More preferably, the rear leaf area 12 includes a rear leaf rear area 121, a rear leaf middle area 122 and a rear leaf front area 123. The rear leaf middle area 122 is angularly distributed along the circumferential direction of the stent body 10. is 0° to 90°, and the angle distribution of the rear leaf area 121 and/or the rear leaf front area 123 along the circumferential direction of the stent body 10 is 60° to 150°. For example, in this embodiment, the angular distribution of the rear area 121 of the rear leaf is 70°, the angular distribution of the middle area 122 of the rear leaf is 30°, and the angular distribution of the front area 123 of the rear leaf is 90°. °. Of course, in other embodiments, those skilled in the art can also make adaptive adjustments. Such arrangement can make different areas of the stent body 10 of the valve stent fit better with the myocardium and native valve leaflets, so that the barbs 21 provided in different areas of the stent body 10 can be more closely aligned with the heart tissue according to anatomical regional divisions. Better targeted connections.

Preferably, please refer to Figure 2, in order to ensure that the valve stent can fix the artificial valve leaflets in the position of the native valve leaflets, allowing them to open and close normally, and control the native valve leaflets not to affect the left ventricular outflow tract blood flow, and at the same time reduce Damage to tissue within the heart. The barb structure 20 may be two rows of barbs 21, or may be three rows or four rows of barbs 21. In any two rows of barbs 21 in the at least two rows of barbs, that is, in different rows Among the barbs 21 , a row of barbs 21 closer to the inflow channel A of the stent body 10 has a smaller number of barbs 21 than other rows of barbs 21 . This is because the position of the valve stent implanted into the native valve needs to make the native valve leaflets bend toward the direction of the outflow tract B. Different rows of barbs 21 are arranged along the axial direction of the stent body 10, and each row of barbs 21 respectively corresponds to a certain radial tissue part of the bent native valve leaflet. When the barbs 21 are stuck on the native valve leaflets, since the edges of the native valve leaflets are not easy to fix, more barbs 21 are needed for fixation. In non-edge areas, it is relatively easy to fix and fewer barbs are needed. 21 for fixation. In this way, the minimum number of barbs 21 can be used for the most stable fixation, thereby reducing additional damage to the heart tissue caused by the barbs 21.

More preferably, as shown in FIGS. 2 to 4 , the barb structure 20 includes two rows of barbs 21 , and the two rows of barbs 21 are respectively a first row of barbs 211 and a second row of barbs 212 . The first row of barbs 211 is closer to the inflow channel A than the second row of barbs 212 . The first row of barbs 211 is used to snap into the middle part of the native valve leaflet. Wherein, the middle part refers to the portion between the annulus of the native valve leaflet and the edge of the native valve leaflet along the axial direction of the stent body 10 . More specifically, the middle portion may represent the middle position of a line connecting the annular end of the native valve leaflet to the edge end of the native valve leaflet. Taking the mitral valve as an example, the first row of barbs 211 are stuck under the valve annulus, thereby fixing the native valve leaflets, so that the valve prosthesis can open and close normally during cardiac systole and diastole. There is a certain distance between the second row of barbs 212 and the first row of barbs 211, and the distance can be set according to actual conditions. The second row of barbs 212 is used to snap into the edge of the native valve leaflet, and mainly controls the edge of the native valve leaflet, so that the native valve leaflet does not hinder the blood flow from the aorta during systole. Wherein, the edge part may represent the edge end of the native valve leaflet.

Furthermore, since the two rows of barbs 21 have different positions and play different roles, the number of the first row of barbs 211 can be smaller than the number of the second row of barbs 212, so that the pair of barbs 21 Damage to cardiac tissue is minimized.

Preferably, the barb structure 20 and the stent body 10 are integrally formed. Specifically, the barb structure 20 can be formed by an integral forming processing method, specifically by an integral cutting method. Of course, in other embodiments, the barb structure 20 and the stent body 10 can also be fixedly connected in other ways, which will not be described again here.

Preferably, the valve stent is made of implantable metal material, such as titanium alloy or cobalt-chromium alloy. Or it can also be made of polymer material, and the polymer material can be polylactic acid (PLA). Of course, the valve stent can also be made of other implantable materials.

This embodiment also provides a valve prosthesis, which includes the valve stent as described above. The valve prosthesis is, for example, an artificial heart valve prosthesis, used for mitral valve or tricuspid valve, etc. The valve prosthesis has the beneficial effects brought by the valve stent, which will not be described in detail here. For other structural components of the valve prosthesis, reference can be made to the prior art and will not be described here.

To sum up, in the valve stent and valve prosthesis provided by this application, the valve stent includes a stent body and a barb structure; the stent body is divided along its own circumferential direction into at least an anterior leaflet area and a posterior leaflet area. The leaf area and the leaflet connection area; the barb structure includes at least two rows of barbs, the barbs are arranged along the circumferential direction of the stent body, and the density of the barbs provided in the leaflet connection area is smaller than the The density of barbs in the front leaf region is not greater than the density of barbs in the posterior leaf region. In this way, the barbs can be made to conform to the physiological anatomical area of the native valve leaflets, so that the degree of damage caused by the barbs to the native valve leaflets and their surrounding tissues is reduced, and the problem of the damage caused by the barbs to the native valve leaflets and their surrounding tissues after the valve stent is implanted is solved. Serious damage problem.

In addition, it should be recognized that although the present application has been disclosed above with preferred embodiments, the above embodiments are not intended to limit the present application. For any person familiar with the art, without departing from the scope of the technical solution of the present application, the technical content disclosed above can be used to make many possible changes and modifications to the technical solution of the present application, or modify it into equivalent changes. Example. Therefore, any simple modifications, equivalent changes and modifications made to the above embodiments based on the technical essence of the present application that do not deviate from the content of the technical solution of the present application still fall within the scope of protection of the technical solution of the present application.

Claims

A valve stent, characterized by including: a stent body and a barbed structure;

The stent body is divided along its own circumferential direction into at least an anterior leaflet area, a posterior leaflet area and a leaflet connection area;

The barb structure includes at least two rows of barbs, each row of barbs is arranged along the circumference of the stent body, and the density of barbs provided in the leaflet connection area is smaller than the barbs in the front leaflet area. The density is no greater than the density of barbs in the posterior leaf area.
The valve stent according to claim 1, wherein the posterior leaflet region includes a posterior leaflet posterior region, a posterior leaflet middle region, and a posterior leaflet front region, and the density of barbs provided in the posterior leaflet middle region is The density of barbs is smaller than the density of the barbs in the posterior region of the posterior lobe and/or the anterior region of the posterior lobe.
The valve stent according to claim 2, wherein the valve leaflet connection area at least includes a valve leaflet front connection area and a valve leaflet rear connection area, and the valve leaflet front connection area, the valve leaflet rear connection area and At least one of the middle regions of the posterior leaves is not provided with any barbs.
The valve stent according to claim 1, wherein the valve leaflet connection area at least includes a valve leaflet front connection area and a valve leaflet rear connection area, and the valve leaflet front connection area and/or the valve leaflet rear connection area The angular distribution of the region along the circumferential direction of the stent body is greater than 0° and less than or equal to 90°, and the angular distribution of the anterior leaf region along the circumferential direction of the stent body is 60° to 180°.
The valve stent according to claim 4, wherein the posterior leaflet region includes a posterior leaflet posterior region, a posterior leaflet middle region, and a posterior leaflet front region, and the posterior leaflet middle region is along the circumference of the stent body. The angular distribution in the circumferential direction of the stent body is 0° to 90°, and the angular distribution of the rear area of the rear leaf and/or the front area of the rear leaf along the circumferential direction of the stent body is 60° to 150°.
The valve stent according to claim 1, wherein in any two rows of barbs among the at least two rows of barbs, the number of barbs in the row closer to the inflow channel of the stent body is less than Another row.
The valve stent according to claim 6, wherein the barb structure includes two rows of barbs, and the two rows of barbs are a first row of barbs and a second row of barbs, and the first row of barbs The barbs are closer to the inflow channel than the second row of barbs, the first row of barbs are used to snap into the middle part of the native valve leaflets, and the second row of barbs are used to snap into the The edge of the native valve leaflet.
The valve stent according to claim 7, wherein the number of barbs in the first row is less than the number of barbs in the second row.
The valve stent according to claim 1, wherein the barb structure is integrally formed with the stent body.
A valve prosthesis, characterized in that the valve prosthesis includes the valve stent according to any one of claims 1-9.