METHODS AND APPARATUS FOR TRANSPERICARDIAL LEFT ATRIAL APPENDAGE CLOSURE

• US 20080125795A1
• Filed: 11/23/2007
• Published: 05/29/2008
• Est. Priority Date: 05/20/1999
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: Aaron V. Kaplan
• Inventors: BAJOR, Jordan T., KAPLAN, Aaron V.
• Granted Patent: US 8,974,473 B2
• Time in Patent Office: Days
• US Class Current: 606/140
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/320048 Balloon dissectors

Abstract

Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Claims

1-10. -10. (canceled)

11. A sub-xiphoid device for closing a left atrial appendage of a heart, said device comprising:

a shaft having an elongated longitudinal body including a proximal end and a distal end, the shaft having a common lumen; and

a closing element, the closing element including;

a grasping tool configured with a retracted position when not in use and an extended position when in use, the retracted position being where the grasping tool is configured to be inside the common lumen of the shaft, the extended position being where the grasping tool is configured to be axially and distally advanced from the proximal end of the shaft and outside the common lumen of the shaft, the grasping tool including one member and another member, the members being movable toward and away from each other, where the grasping tool is configured to temporarily grasp the left atrial appendage when the members are moved toward each other, and

a closure loop configured with a retracted position when not in use and an extended position when in use, the retracted position being where the closure loop is configured to be within the common lumen of the shaft, the extended position being where the closure loop is configured to be axially and distally advanced from the proximal end of the shaft and outside the common lumen of the shaft, the closure loop is configured to advance over the grasping tool and around the left atrial appendage, and the closure loop is configured to be cinched to close the left atrial appendage,

the grasping tool and the closure loop being disposed in the common lumen of the shaft when retracted, and the grasping tool and closure loop configured to extend from the common lumen proximate the distal end of the shaft when used.

12. The device of claim 11, wherein the shaft includes a plurality of lumens, the closing element is configured to extend through one of the lumens.

13. The device as in claim 11, wherein the shaft is configured to adjust its curvature.

14. The device as in claim 11, wherein the closure loop is configured to permanently close the left atrial appendage.

15. The device as in claim 11, wherein the grasping tool is only a two-member jaw-like construction, the members of the grasping tool being movable toward and away from each other, where the grasping tool is configured to temporarily grasp the left atrial appendage when the two members are moved toward each other.

16. A sub-xiphoid system for closing a left atrial appendage of a heart, said system comprising:

a sub-xiphoid device; and

an expandable member configured to be disposed at a location on a epicardial surface within a pericardial space, the expandable member being expandable between the epicardial surface and a parietal pericardium,

the sub-xiphoid device including;

a shaft having an elongated longitudinal body including a proximal end and a distal end, the shaft having a common lumen, and

a closing element having

a grasping tool configured with a retracted position when not in use and an extended position when in use, the retracted position being where the grasping tool is configured to be inside the common lumen of the shaft, the extended position being where the grasping tool is configured to be axially and distally advanced from the proximal end of the shaft and outside the common lumen of the shaft, the grasping tool including one member and another member, the members being movable toward and away from each other, where the grasping tool is configured to temporarily grasp the left atrial appendage when the members are moved toward each other, and

a closure loop configured with a retracted position when not in use and an extended position when in use, the retracted position being where the closure loop is configured to be within the common lumen of the shaft, the extended position being where the closure loop is configured to be axially and distally advanced from the proximal end of the shaft and outside the common lumen of the shaft, the closure loop is configured to advance over the grasping tool and around the left atrial appendage, and the closure loop is configured to be cinched to close the left atrial appendage,

the grasping tool and the closure loop being disposed in the common lumen of the shaft when retracted, and the grasping tool and closure loop configured to extend from the common lumen proximate the distal end of the shaft when used.