Apparatus and method for the ligation of tissue

• US 20070073313A1
• Filed: 11/15/2006
• Published: 03/29/2007
• Est. Priority Date: 10/09/2003
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: Cohn, William, Laham, Roger, Liddicoat, John
• Granted Patent: US 7,828,810 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/12018 Elastic band ligators
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2576/023 for the heart
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61M 25/0108 using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0127 Magnetic means; Magnetic markers
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.

Claims

1. A method for closing the left atrial appendage of a patient'"'"'s heart, comprising the steps of:

inserting a first guide member having a first alignment element located at a distal end into the left atrial appendage;

inserting a second guide member having a second alignment element located at a distal end into a pericardial space of the patient;

aligning the first and second alignment elements;

advancing a ligating element over the second elongate member to a position adjacent the left atrial appendage; and

closing the left atrial appendage using the ligating element.

2. The method of claim 1, wherein the first guide member further comprises radiopaque material, and wherein the step of inserting the first guide member is visualized using fluoroscopy.

3. The method of claim 1, wherein the step of inserting the first guide member is visualized using ultrasound.

4. The method of claim 1, wherein the first guide member further comprises an expandable element located near the distal end.

5. The method of claim 4, further comprising the step of expanding the expandable element within the left atrial appendage before closing the left atrial appendage using the closure instrument.

6. The method of claim 4, wherein the expandable element is an inflatable balloon.

7. The method of claim 1, wherein the first and second alignment elements are magnets.

8. The method of claim 1, wherein the pericardial space is accessed by making an incision below the zyphoid process.

9. The method of claim 1, wherein the pericardial space is accessed by making an incision over the second costal cartilage.

10. The method of claim 1, wherein the ligating element comprises a nitinol structure with a suture.

11. The method of claim 1, wherein the ligating element comprises a suture.

12. The method of claim 11, wherein the suture is made from polypropylene or PTFE.