Assembly and method for left atrial appendage occlusion

• US 10,314,594 B2
• Filed: 12/14/2012
• Issued: 06/11/2019
• Est. Priority Date: 12/14/2012
• Status: Active Grant

• Current Assignee: Corquest Medical, Inc. (Celyad Oncology SA)
• Original Assignee: Corquest Medical, Inc. (Celyad Oncology SA)
• Inventors: de Canniere, Didier
• Primary Examiner(s): Erezo, Darwin P
• Assistant Examiner(s): Herbermann, Erich
• Application Number:
  US13/714,989
• Publication Number:
  US 20140172004A1
• Time in Patent Office: 2,370 Days
• Field of Search: 606157, 606158, 606213, 606200
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 17/12177 comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00597 Implements comprising a membrane
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device

Abstract

An assembly and method for performing the occlusion of the left atrial appendage including a delivery instrument being positioned in communicating relation with the interior of the left atrial appendage and disposing a distal end portion of the delivery instrument in covering relation to the entrance thereof. Occlusion material is movably connected to the delivery instrument and includes at least one elongated single strand of flexible material. A length of the single strand is progressively fed through the delivery instrument into the interior of the left atrial appendage and the flexibility thereof is sufficient to progressively form an arbitrarily intermingled array of occlusion material therein. The dimension and configuration of the formed arbitrarily intermingled array is sufficient to fill a predetermined portion of the interior of the left atrial appendage and thereby conform to the configuration thereof.

Claims

1. An assembly for performing left atrial appendage occlusion comprising:

a delivery instrument including a distal end portion, said distal end portion comprising a cover structure removably connected to said delivery instrument,

occlusion material including at least one elongated, single strand of flexible material movably connected to said delivery instrument,

said delivery instrument structured to dispose said distal end portion and said occlusion material in communicating relation with an interior of the left atrial appendage,

said at least one single strand disposable axially outwardly from said delivery instrument into the interior of the left atrial appendage,

said at least one single strand having sufficient flexibility to define an arbitrarily intermingled array of occlusion material when disposed within the interior of the left atrial appendage,

said cover structure having a covering orientation, said covering orientation comprising said cover structure disconnected from said delivery instrument and disposed in covering relation to an entrance to the left atrial appendage,

said cover structure comprising a plurality of ribs each having a free distal end configured to engage an outer periphery of the entrance of the left atrial appendage and connect said cover structure thereto in said covering orientation, and

said at least one single strand including a proximal end and a distal end each remaining connected to said cover structure concurrent to said cover structure being in said covering orientation and a remaining portion of said at least one single strand being disposed within the interior of the left atrial appendage in said arbitrarily intermingled array,

wherein said at least one single strand forming the arbitrarily intermingled array is unconnected to itself along its length and is unconnected to tissue portions of the heart corresponding to the left atrial appendage when the cover structure is in said covering orientation, and

wherein when in the covering orientation, each of said plurality of ribs extend radially outwardly and do not project distally of the distal end of the distal end portion.

2. An assembly as recited in claim 1 wherein the length of said at least one single strand is progressively fed outwardly from said distal end portion into the interior of the left atrial appendage to form said arbitrarily intermingled array therein.

3. An assembly as recited in claim 2 wherein at least a portion of the length of said at least one single strand is movably disposed on said delivery instrument and progressively movable through and outwardly from said distal end portion into said arbitrarily intermingled array within the left atrial appendage.

4. An assembly as recited in claim 1 wherein said arbitrarily intermingled array is dimensioned to fill at least a majority of the interior of the left atrial appendage.

5. An assembly as recited in claim 4 wherein said arbitrarily intermingled array is dimensioned to substantially correspond to an interior configuration of the left atrial appendage.

6. An assembly as recited in claim 1 wherein said arbitrarily intermingled array is dimensioned to fill substantially an entire interior of the left atrial appendage and substantially conform to an interior configuration thereof.

7. An assembly as recited in claim 6 wherein at least a portion of the length of said at least one single strand is movably disposed within an interior of said delivery instrument and progressively movable through and outwardly from said distal end portion into said arbitrarily intermingled array within the left atrial appendage.

8. An assembly as recited in claim 1 wherein the length of said remaining portion of said at least one single strand is progressively fed outwardly from said distal end portion into the interior of the left atrial appendage to define said arbitrarily intermingled array therein.

9. An assembly as recited in claim 8 wherein at least a portion of the length of said at least one single strand is movably disposed within an interior of said delivery instrument and progressively movable through said distal end portion into said arbitrarily intermingled array within the left atrial appendage.

10. An assembly as recited in claim 1 wherein said cover structure is movable relative to a remainder of said delivery instrument and selectively expanded into said covering orientation, said cover structure being of sufficient dimension and configuration to cover the entrance of the left atrial appendage.

11. An assembly as recited in claim 10 wherein said covering orientation comprises a radially outward expansion of said cover structure relative to a central axis of said distal end portion.

12. An assembly as recited in claim 1 wherein said covering orientation further comprises said cover structure disposed at least partially disposed exteriorly of the entrance of the left atrial appendage.

13. An assembly as recited in claim 1 wherein said covering orientation further comprises an outer face of said cover structure disposed exteriorly of the entrance of the left atrial appendage and formed of a liquid impermeable material disposed and structured to restrict fluid flow there through into the interior of the left atrial appendage.

14. An assembly as recited in claim 1 wherein at least a portion of the length of said at least one single strand is movably disposed within said delivery instrument and progressively movable through an inner extremity of said cover structure into said arbitrarily intermingled array within the left atrial appendage when said cover structure is in said covering orientation.

15. An assembly for performing left atrial appendage occlusion comprising:

a delivery instrument including a distal end portion,

said distal end portion comprising a cover structure removably connected to said delivery instrument,

a plurality of elongated ribs connected to said cover structure along their length, each of said plurality of elongated ribs comprising a free distal end configured to engage an outer periphery of an entrance of the left atrial appendage and connect said cover structure thereto in a covering orientation,

occlusion material including at least one elongated, single strand of flexible material movably connected to said delivery instrument,

said delivery instrument structured to dispose said distal end portion and said occlusion material in communicating relation with an interior of the left atrial appendage,

a length of said at least one single strand disposed axially outwardly from said cover structure into the interior of the left atrial appendage in the form of an arbitrarily intermingled array, said arbitrarily intermingled array dimensioned to fill at least a majority of the interior of the left atrial appendage,

said arbitrarily intermingled array including a proximal end and a distal end each remaining connected to said cover structure upon disconnection of said cover structure from a remainder of said delivery instrument and concurrent to said cover structure being disposed in a covering orientation, and

said covering orientation comprising said cover structure at least partially disposed on an exterior of the entrance to the left atrial appendage and in covering relation to the entrance,

wherein said at least one single strand forming the arbitrarily intermingled array is unconnected to itself along its length and is unconnected to tissue portions of the heart corresponding to the left atrial appendage when the cover structure is in said covering orientation and when said cover structure is disconnected from the remainder of said delivery instrument, and

wherein when in the covering orientation, each of said plurality of elongated ribs extend radially outwardly and do not project distally of the distal end of the distal end portion.

16. An assembly for performing left atrial appendage occlusion comprising:

a delivery instrument including a distal end portion, said distal end portion comprising a cover structure removably connected to said delivery instrument,

occlusion material including at least one elongated, single strand of flexible material movably connected to said delivery instrument,

said delivery instrument structured to dispose said distal end portion and said occlusion material in communicating relation with an interior of the left atrial appendage,

said at least one single strand disposable outwardly from said delivery instrument into the interior of the left atrial appendage,

said at least one single strand having sufficient flexibility to define an arbitrarily intermingled array of occlusion material when disposed within the interior of the left atrial appendage,

said cover structure having a covering orientation, said covering orientation comprising said cover structure disconnected from said delivery instrument and disposed in covering relation to an entrance to the left atrial appendage,

said cover structure comprising a plurality of ribs each having a free distal end configured to engage an outer periphery of the entrance of the left atrial appendage and connect said cover structure thereto in said covering orientation,

said at least one single strand including a proximal end and a distal end each remaining connected to said cover structure concurrent to said cover structure being in said covering orientation and a remaining portion of said at least one single strand being disposed within the interior of the left atrial appendage in said arbitrarily intermingled array,

wherein said at least one single strand forming the arbitrarily intermingled array is unconnected to itself along its length and is unconnected to tissue portions of the heart corresponding to the left atrial appendage when the cover structure is in said covering orientation, and

wherein the at least one single strand is deployable axially outwardly from said delivery instrument independently of said plurality of ribs, and

wherein when in the covering orientation, each of said plurality of ribs extend radially outwardly and do not project distally of the distal end of the distal end portion.

17. An assembly for performing left atrial appendage occlusion comprising:

a delivery instrument including a distal end portion,

said distal end portion comprising a cover structure removably connected to said delivery instrument,

a plurality of elongated ribs connected to said cover structure along their length, each of said plurality of elongated ribs comprising a free distal end configured to engage an outer periphery of the entrance of the left atrial appendage and connect said cover structure thereto in a covering orientation,

occlusion material including at least one elongated, single strand of flexible material movably connected to said delivery instrument,

said delivery instrument structured to dispose said distal end portion and said occlusion material in communicating relation with an interior of the left atrial appendage,

a length of said at least one single strand disposed outwardly from said cover structure into the interior of the left atrial appendage in the form of an arbitrarily intermingled array, said arbitrarily intermingled array dimensioned to fill at least a majority of the interior of the left atrial appendage,

said arbitrarily intermingled array including a proximal end and a distal end each remaining connected to said cover structure upon disconnection of said cover structure from a remainder of said delivery instrument and concurrent to said cover structure being disposed in a covering orientation;

said covering orientation comprising said cover structure at least partially disposed on an exterior of an entrance to the left atrial appendage and in covering relation to the entrance,

wherein said at least one single strand forming the arbitrarily intermingled array is unconnected to itself along its length and is unconnected to tissue portions of the heart corresponding to the left atrial appendage when the cover structure is in said covering orientation and when said cover structure is disconnected from the remainder of said delivery instrument, and

wherein the at least one single strand is deployable axially outwardly from said delivery instrument independently of said plurality of ribs, and

wherein when in the covering orientation, each of said plurality of ribs extend radially outwardly and do not project distally of the distal end of the distal end portion.