Devices for closing the left atrial appendage

• US 9,498,223 B2
• Filed: 01/30/2009
• Issued: 11/22/2016
• Est. Priority Date: 03/30/2007
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: Miller, Gary H., Seiber, Russell A., Fung, Gregory W.
• Primary Examiner(s): Templeton, Christopher L
• Application Number:
  US12/363,359
• Publication Number:
  US 20090157118A1
• Time in Patent Office: 2,853 Days
• Field of Search: 606/148, 606/139, 606/113, 606/144, 119802-805, 600/127, 600/129
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• 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

Abstract

Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture.

Claims

1. A device for closing a left atrial appendage comprising:

an elongate body having a proximal end and a distal end;

a closure element assembly comprising a retention member and a closure element, wherein the closure element is at least partially housed within the elongate body, and wherein the closure element comprises a loop defining a continuous aperture therethrough, a first end of the closure element fixed within the elongate body, and a second end of the closure element moveable relative to the elongate body;

a suture comprising a suture knot and a suture loop extending from the suture knot, wherein the suture loop is at least partially releasably disposed within the retention member; and

a suture hook positioned in the elongate body and proximal to the suture knot and the retention member, wherein the suture hook is holding a portion of the suture loop within the elongate body.

2. The device of claim 1, wherein the closure element is made at least in part from a shape-memory material.

3. The device of claim 2, wherein the closure element is made at least in part from a nickel titanium alloy.

4. The device of claim 1, wherein the suture is bioabsorbable.

5. The device of claim 1, wherein the suture is non-bioabsorbable.

6. The device of claim 1, wherein the retention member has at least one lumen therein.

7. The device of claim 1, wherein the retention member has a weakened region configured to release the suture upon the application of a force.

8. The device of claim 1, wherein the retention member has a perforated region configured to release the suture upon the application of a force.

9. The device of claim 1, wherein the retention member has at least one slit extending along at least a portion thereof.

10. The device of claim 9, wherein the suture is configured to pass through the at least one slit.

11. The device of claim 1, wherein the retention member is made at least in part from a polymer.

12. The device of claim 1, wherein the elongate body has one or more curves along its length.

13. The device of claim 1, wherein the elongate body is steerable.

14. The device of claim 1, wherein the elongate body is a catheter.

15. The device of claim 1, wherein the closure element, suture, or both comprise a radiopaque or echogenic material.

16. The device of claim 1, wherein the device further comprises a handle including a slide that actuates the closure element to reduce a circumference thereof.

17. The device of claim 1, wherein the closure element and the suture are separately actuatable.