Method for closure and ablation of atrial appendage

• US 10,786,302 B2
• Filed: 10/09/2015
• Issued: 09/29/2020
• Est. Priority Date: 10/09/2015
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Iaizzo, Paul A., Goff, Ryan P.
• Primary Examiner(s): Peffley, Michael F
• Assistant Examiner(s): Good, Samantha M
• Application Number:
  US14/879,399
• Publication Number:
  US 20170100183A1
• Time in Patent Office: 1,817 Days
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00358 Snares for grasping
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0225 using an instrument for clamping tissue, e.g. forceps
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61B 2018/0293 using an instrument interstitially inserted into the body, e.g. needle
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

A device, system, and method for ligating the left atrial appendage without creating pro-arrhythmic tissue. The device may generally include a snare including a thermally transmissive distal portion and a suture including a distal portion, both distal portions having a lasso-shaped configuration that may be positioned proximate the base of the left atrial appendage. Once the distal portions of the snare and the suture are tightened around the base of the left atrial appendage, the thermally transmissive distal portion of the snare may be activated to create an ablation lesion in adjacent left atrial appendage tissue. The lesion may be created with radiofrequency energy or through cryoablation by the circulation of refrigerant within the thermally transmissive distal portion of the snare.

Claims

1. A device for ligating a left atrial appendage, the device comprising:

a first elongate body including a proximal portion and a thermally transmissive distal portion;

a second elongate body having a proximal portion and a distal portion, the distal portion of the second elongate body being releasably engageable with the proximal portion of the second elongate body;

the thermally transmissive distal portion of the first elongate body having a lasso configuration, the thermally transmissive distal portion of the first elongate body including a slidable element slidably engaged with the second elongate body;

the distal portion of the second elongate body having a lasso configuration, the distal portion of the second elongate body being disposed around the first elongate body; and

an anchoring device configured to be anchored to the left atrial appendage, the anchoring device comprising;

a third elongate body having a first portion and a second portion;

a first magnet; and

a second magnet, the first portion having the first magnet and the second portion having the second magnet, the first portion and the second portion being secured together through the left atrial appendage by the first magnet and the second magnet, the lasso-shaped configuration of the thermally transmissive distal portion of the first elongate body and the lasso-shaped configuration of the distal portion of the second elongate body configured to be advanced over the third elongate body.

2. The device of claim 1, wherein the lasso-shaped configuration of the thermally transmissive distal portion of the first elongate body has an adjustable diameter.

3. The device of claim 1, wherein the lasso-shaped configuration of the distal portion of the second elongate body has an adjustable diameter.

4. The device of claim 1, the device further including a first sheath and a second sheath being disposed about at least a portion of the first sheath, at least a portion of each of the first elongate body and the second elongate body being within the first sheath, the first sheath being slidable relative to the first elongate body, second elongate body, and the second sheath.

5. The device of claim 1, wherein the thermally transmissive distal portion of the first elongate body is configured to transmit radiofrequency energy.

6. The device of claim 5, wherein at least the thermally transmissive distal portion of the first elongate body is composed of an electrically conductive material.

7. The device of claim 1, wherein the first elongate body defines a fluid lumen therein, the fluid lumen being configured to be in fluid communication with a source of refrigerant.

8. The device of claim 7, wherein the thermally transmissive distal portion of the first elongate body is configured to reach a temperature that is sufficiently low enough to ablate adjacent tissue.