Left atrial appendage devices and methods

• US 10,098,640 B2
• Filed: 09/20/2010
• Issued: 10/16/2018
• Est. Priority Date: 12/04/2001
• Status: Expired due to Fees

• Current Assignee: Atricure, Inc.
• Original Assignee: Atricure, Inc.
• Inventors: Bertolero, Arthur A., Ibrahim, Tamer, Geyster, Steve
• Primary Examiner(s): Yabut, Diane
• Application Number:
  US12/886,436
• Publication Number:
  US 20110009853A1
• Time in Patent Office: 2,948 Days
• Field of Search: 606151
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac

Abstract

Devices and methods for clamping tissue and/or moving two tissue structures together by moving two plates or arm together. The pressure or force applied to the tissue may be used to bring the tissue together, to seal an opening or to cut through and remove a portion of the tissue. In one procedure disclosed, a clip applier may be used to apply one or more clips to the left atrial appendage of the heart to prevent clots from the left atrial appendage from embolizing and causing harm to the patient, such as a stroke.

Claims

1. A method of segregating an atrial appendage of a patient with an atrial segregation device during a cardiac surgical treatment, the method comprising:

delivering the atrial segregation device to the atrial appendage of the patient using an applier device, wherein the atrial segregation device comprises a biocompatible material, the atrial segregation device comprising a first arm extending parallel to a second arm where the first arm and second arm are joined at first and second ends of the atrial segregation device such that the atrial segregation device is slid over the atrial appendage while connected to the applier device;

compressing the first and second arms of the atrial segregation device onto the atrial appendage by moving the first arm towards the second arm using the applier device while the atrial segregation device is engaged with the applier device; and

segregating the atrial appendage of the patient with the atrial segregation device and releasing the atrial segregation device from the applier device.

2. The method of claim 1, wherein the atrial segregation device is left in place after surgery.

3. The method of claim 1, wherein the atrial segregation device is applied under direct visualization.

4. The method of claim 1, wherein the atrial segregation device is applied via a direct intercostal approach between ribs of a patient.

5. The method of claim 1, wherein the atrial segregation device is applied via a direct intercostal approach between the 4th through 6th intercostal spaces.

6. The method of claim 1, wherein a tissue region adjacent to the atrial segregation device is dissected distal to the atrial segregation device.

7. The method of claim 1, further comprising:

manipulating the atrial appendage between the first arm and second arm of the atrial segregation device.

8. The method of claim 7, wherein manipulating the atrial appendage is performed by suction.

9. The method of claim 1, further comprising using suction during delivering the atrial segregation device to the atrial appendage.

10. The method of claim 9, wherein the suction is applied with the use of a separate suction device.

11. The method claim of 1, wherein the atrial segregation device comprises a superelastic material.

12. The method of claim 1, further comprising:

applying at least one staple to maintain a pressure on the atrial appendage.

13. The method of claim 1, further comprising applying at least one rivet to the atrial appendage.

14. The method of claim 1, further comprising applying at least one suture to maintain a pressure on the atrial appendage.

15. The method of claim 1, further comprising applying RF energy to the atrial appendage.

16. The method of claim 1, further comprising applying an adhesive to the atrial appendage.

17. The method of claim 16, wherein applying the adhesive comprises applying the adhesive on at least one elongated plate of the atrial segregation device.

18. The method of claim 1, further comprising:

applying laser energy to the tissue to maintain segregating the atrial appendage.

19. The method of claim 1, wherein compressing the first and second arms of the atrial segregation device onto the atrial appendage comprises displacing two portions of the atrial appendage simultaneously.

20. The method of claim 1, wherein compressing the atrial segregation device onto the atrial appendage comprises displacing two portions of the atrial appendage sequentially.

21. The method of claim 1, wherein:

the first and second arms of the atrial segregation device comprise opposing surfaces of a size and shape to engage opposite sides of the atrial appendage;

each of the opposing surfaces includes a plurality of teeth; and

applying pressure with the atrial segregation device comprises engaging the teeth with the outer surfaces of the atrial appendage.

22. The method of claim 21, further comprising locking the atrial segregation device in a closed position.

23. The method of claim 1, wherein the atrial appendage is positioned external to an atrium to which the atrial appendage is attached.

24. The method of claim 1, wherein compressing the first and second arms of the atrial segregation device onto the atrial appendage comprises using a clamp on the applier device to exert pressure to close the atrial segregation device.

25. The method of claim 1, further comprising locking the first and second arms at the second end of the atrial segregation device comprises limiting a tension in the atrial segregation device to prevent application of an excessive force while segregating the atrial appendage.