Left Atrial Appendage Closure via Dual-Guide Alignment
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Solution Overview
Problem
Current methods for closing the left atrial appendage, such as open-heart surgery and occlusion devices, are invasive, risky, and not effective in preventing all thrombus formation, necessitating the development of minimally invasive or intravascular techniques for safe and efficient closure.
Innovation Solution
The use of guide members with alignment features and closure devices comprising an elongate body with a looped closure element, advanced under visualization techniques, to position and secure the left atrial appendage, potentially with expandable members and sutures for optimal closure and exclusion from systemic circulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If open-heart surgery is used to suture the base of the left atrial appendage, then complete closure and thrombus prevention is achieved, but the procedure becomes highly invasive with significant surgical risks and requires general anesthesia
Solution Approach 1:
The patent replaces the mechanical surgical suturing system with a percutaneous delivery system that uses catheter-based devices to achieve appendage closure. The closure device is delivered through a catheter inserted via the venous system, eliminating the need for surgical incisions, general anesthesia, and open chest procedures while achieving comparable closure effectiveness
Solution Approach 2:
The patent introduces a percutaneous access pathway as an intermediary approach between open surgery and simple occlusion devices. The catheter serves as a mediator that delivers the closure device through the venous system to the left atrial appendage, providing a less invasive route that maintains closure effectiveness while reducing surgical trauma
2Object-affected harmful factors
If simple occlusion devices are used to fill the left atrial appendage, then the procedure is less invasive, but the devices may not effectively prevent all blood flow into the appendage
Solution Approach 1:
The patent employs a closure device with a dynamic structure that can be delivered in a compressed state through a catheter and then expanded within the left atrial appendage. The device transitions from a low-profile delivery configuration to a fully expanded closure configuration, enabling effective occlusion of the appendage while maintaining percutaneous access and reducing invasiveness
Solution Approach 2:
The patent changes the physical parameters of the closure device during delivery and deployment. The device is delivered in a compressed, low-volume state through the catheter, then expanded to a larger volume within the appendage to achieve complete occlusion. This parameter transformation allows the device to be both minimally invasive during delivery and highly effective at preventing blood flow and thrombus formation
Data Source
AI summary
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 therethrough.