Methods and apparatus for transpericardial left atrial appendage closure

• US 8,721,663 B2
• Filed: 06/14/2011
• Issued: 05/13/2014
• Est. Priority Date: 05/20/1999
• Status: Expired due to Fees

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: Kaplan, Aaron V., Bajor, Jordan T.
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US13/160,441
• Publication Number:
  US 20120158022A1
• Time in Patent Office: 1,064 Days
• Field of Search: 606/113, 606139-142, 606/144, 606/148, 606/153, 606/159, 606/191, 606/192, 606/198, 128/898
• US Class Current: 606/139
• 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. A method for closing the left atrial appendage comprising:

advancing a sheath into the pericardial space using a percutaneous approach;

advancing a tissue grasper through the sheath;

grasping the left atrial appendage with the grasper;

advancing a loop over the tissue grasper to encircle the left atrial appendage;

tightening the loop to close the left atrial appendage.

2. The method of claim 1 further comprising advancing an expandable member into the pericardial space and expanding the expandable member to raise a portion of the pericardium.

3. The method of claim 2 wherein the expandable member comprises a balloon.

4. The method of claim 1 wherein the method is visualized using fluoroscopic imaging.