Apparatus and method for the ligation of tissue
First Claim
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1. A method for closing a left atrial appendage of a patient'"'"'s heart, comprising:
- advancing a guide member transeptally into the left atrial appendage, wherein the guide member comprises an expandable element;
advancing a ligating assembly from the outside of a patient'"'"'s heart to a position adjacent to the left atrial appendage, wherein the ligating assembly comprises a support and a loop releasably attached to the support;
advancing the ligating assembly over an exterior surface of the left atrial appendage and over the expandable element so that the loop encircles the base of the left atrial appendage;
expanding the expandable element within the left atrial appendage;
closing the left atrial appendage with the ligating assembly;
confirming that the loop encircles the base of the left atrial appendage using fluoroscopy, echocardiographic guidance, or a combination thereof, prior to releasing the loop from the support;
releasing the loop from the support;
contracting and withdrawing the expandable element from the left atrial appendage; and
re-tightening the loop.
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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.
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Citations
23 Claims
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1. A method for closing a left atrial appendage of a patient'"'"'s heart, comprising:
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advancing a guide member transeptally into the left atrial appendage, wherein the guide member comprises an expandable element; advancing a ligating assembly from the outside of a patient'"'"'s heart to a position adjacent to the left atrial appendage, wherein the ligating assembly comprises a support and a loop releasably attached to the support; advancing the ligating assembly over an exterior surface of the left atrial appendage and over the expandable element so that the loop encircles the base of the left atrial appendage; expanding the expandable element within the left atrial appendage; closing the left atrial appendage with the ligating assembly; confirming that the loop encircles the base of the left atrial appendage using fluoroscopy, echocardiographic guidance, or a combination thereof, prior to releasing the loop from the support; releasing the loop from the support; contracting and withdrawing the expandable element from the left atrial appendage; and re-tightening the loop. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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Specification