Apparatus and method for the ligation of tissue

• US 9,271,819 B2
• Filed: 05/20/2008
• Issued: 03/01/2016
• Est. Priority Date: 10/09/2003
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: Liddicoat, John R., Cohn, William E., Laham, Roger
• Primary Examiner(s): TANNER, JOCELIN C
• Application Number:
  US12/124,023
• Publication Number:
  US 20080221593A1
• Time in Patent Office: 2,842 Days
• Field of Search: 606/41, 606/139, 606/49, 606/32, 606/34, 606/200, 606/191, 606/194, 606/148, 606/157, 606110-115, 606/127, 606/128, 606/213, 606/151, 606/144, 606/198, 606/192, 604/104, 604/106, 604/107, 604/508, 604/95.04, 604/500, 604/524, 604/526, 604/22, 604/115, 607/5, 607/122, 607/126, 607/9, 128/887
• US Class Current: 1/1
• 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
• 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 kit comprising:

first and second alignment members, wherein the first and second alignment members are configured to align with one another, wherein the second alignment member has a size and a length adapted for accessing the pericardial space and the first member has a size and a length adapted for accessing the left atrial appendage through the vasculature, and wherein the first alignment member comprises a guidewire and a guide catheter comprising a lumen and a balloon, and wherein the guidewire is slidably positioned through the lumen of the guide catheter; and

a closure device comprising an elongate body comprising a lumen therethrough, a suture loop releasably attached to an expandable structure moveable between a first low-profile configuration and a second expanded configuration, wherein the expandable structure is at least partially within the lumen in the first low-profile configuration and wherein advancement of the expandable structure to the second expanded configuration holds the suture loop in a configuration for placement around the left atrial appendage, and wherein the second alignment member is slidably positioned through the lumen of the elongate body.

2. The kit of claim 1, wherein the first and second alignment members comprise magnets.

3. The kit of claim 1, wherein the first and second alignment members comprise electromagnets.

4. The kit of claim 1, wherein the guide catheter is attached to the first alignment member.

5. The kit of claim 1, wherein the closure device comprises a delivery catheter.

6. The kit of claim 5, wherein the expandable structure is bell-shaped when expanded.

7. The kit of claim 5, wherein the expandable structure is self-expandable.

8. The kit of claim 5, wherein the expandable structure comprises expandable arms.

9. The kit of claim 8, wherein the expandable arms comprise springs.

10. The kit of claim 1, wherein the suture loop comprises polypropylene or PTFE.

11. The kit of claim 1, wherein the closure device comprises a suction tube.

12. The kit of claim 1, wherein the first and second alignment members comprise radio-opaque materials.