US6488689B1
Expired / Lapsed
US
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Methods and apparatus for transpericardial left atrial appendage closure
Assignee: Silicon Valley Bank Inc
•
Filing: 1999-05-20
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Granted: 2002-12-03
•
Expires: 2019-05-20
Abstract
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.
Inventors
- 👤 Aaron V. Kaplan
- 👤 Jordan T. Bajor
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 09:37
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/12; A61B17/12009; A61B17/12013; A61B17/10; A61B17/122; A61B17/128; A61B17/1285; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B17/32; A61B2017/320044; A61B2017/320048
Claims Analysis
Total Claims: 44
Claim 1
Independent Claim
76 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: making an incision between a costal cartilage and a xiphoid of the patient; placing an access sheath through the incision into a pericardial space; positioning a closure instrument through the access sheath into the pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage; and closing the left atrial appendage using the closure instrument.
Claim 2
Independent Claim
76 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: making an incision between a costal cartilage and a xiphoid of the patient; placing an access sheath through the incision into a pericardial space; positioning a closure instrument through the access sheath into the pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage; and closing the left atrial appendage using the closure instrument.
Claim 3
Dependent Claim
38 words
A method as in claim 1 , wherein positioning further comprises advancing a distal end of the closure instrument through the sheath, into the pericardial space, and over an epicardial surface to an atrioventricular groove of the heart.
Claim 4
Dependent Claim
27 words
A method as in claim 2 , wherein closing comprises looping, suturing, stapling, clipping, riveting, clamping, or fusing the left atrial appendage at a neck region thereof.
Claim 5
Dependent Claim
23 words
A method as in claim 3 , wherein closing further comprises grasping the left atrial appendage prior to closing the neck region thereof.
Claim 6
Dependent Claim
18 words
A method as in claim 1 , wherein the method is performed while the patient's heart is beating.
Claim 7
Dependent Claim
20 words
A method as in claim 5 , wherein the method is performed while both lungs of the patient remain inflated.
Claim 8
Dependent Claim
20 words
A method as in claim 6 , wherein the method is performed while the patient is under a local anesthetic.
Claim 9
Dependent Claim
72 words
An improved method for closing a left atrial appendage of a heart, said method being of the type wherein a closure element is placed over an exterior of the appendage while the patient's chest remains closed, wherein the improvement comprises advancing the closure element from beneath the rib cage over an epicardial surface to the exterior of the left atrial appendage prior to placing the closure element over the left atrial appendage.
Claim 10
Dependent Claim
72 words
An improved method for closing a left atrial appendage of a heart, said method being of the type wherein a closure element is placed over an exterior of the appendage while the patient's chest remains closed, wherein the improvement comprises advancing the closure element from beneath the rib cage over an epicardial surface to the exterior of the left atrial appendage prior to placing the closure element over the left atrial appendage.
Claim 11
Dependent Claim
36 words
A method as in claim 1 , further comprising separating the parietal pericardium from the visceral pericardium near left atrial appendage prior to closing the left atrial appendage to create a space over the atrial appendage.
Claim 12
Dependent Claim
16 words
A method as in claim 9 , further comprising viewing the atrial appendage through the space.
Claim 13
Independent Claim
58 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: positioning a closure instrument through a percutaneous passage into a pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, without passing through the pleural space; and closing the left atrial appendage using the closure instrument.
Claim 14
Independent Claim
58 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: positioning a closure instrument through a percutaneous passage into a pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, without passing through the pleural space; and closing the left atrial appendage using the closure instrument.
Claim 15
Dependent Claim
35 words
A method as in claim 11 , wherein positioning comprises making an incision between a costal cartilage and a xiphoid of the patient and placing an access sheath through the incision into the pericardial space.
Claim 16
Dependent Claim
38 words
A method as in claim 12 , wherein positioning further comprises advancing a distal end of the closure instrument through the sheath, into the pericardial space, and over an epicardial surface to an atrioventricular groove of the heart.
Claim 17
Dependent Claim
27 words
A method as in claim 13 , wherein closing comprises looping, suturing, stapling, clipping, riveting, clamping, or fusing the left atrial appendage at a neck region thereof.
Claim 18
Dependent Claim
23 words
A method as in claim 14 , wherein closing further comprises grasping the left atrial appendage prior to closing the neck region thereof.
Claim 19
Dependent Claim
18 words
A method as in claim 11 , wherein the method is performed while the patient's heart is beating.
Claim 20
Dependent Claim
20 words
A method as in claim 16 , wherein the method is performed while both lungs of the patient remain inflated.
Claim 21
Dependent Claim
20 words
A method as in claim 17 , wherein the method is performed while the patient is under a local anesthetic.
Claim 22
Dependent Claim
37 words
A method as in claim 11 , further comprising separating the parietal pericardium from the visceral pericardium near the left atrial appendage prior to closing the left atrial appendage to create a space over the atrial appendage.
Claim 23
Dependent Claim
16 words
A method as in claim 19 , further comprising viewing the atrial appendage through the space.
Claim 24
Independent Claim
60 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: positioning a closure instrument through a percutaneous passage into a pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, while both lungs of the patient remain inflated; and closing the left atrial appendage using the closure instrument.
Claim 25
Independent Claim
60 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: positioning a closure instrument through a percutaneous passage into a pericardial space beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, while both lungs of the patient remain inflated; and closing the left atrial appendage using the closure instrument.
Claim 26
Dependent Claim
35 words
A method as in claim 21 , wherein positioning comprises making an incision between a costal cartilage and a xiphoid of the patient and placing an access sheath through the incision into the pericardial space.
Claim 27
Dependent Claim
38 words
A method as in claim 22 , wherein positioning further comprises advancing a distal end of the closure instrument through the sheath, into the pericardial space, and over an epicardial surface to an atrioventricular groove of the heart.
Claim 28
Dependent Claim
27 words
A method as in claim 23 , wherein closing comprises looping, suturing, stapling, clipping, riveting, clamping, or fusing the left atrial appendage at a neck region thereof.
Claim 29
Dependent Claim
23 words
A method as in claim 24 , wherein closing further comprises grasping the left atrial appendage prior to closing the neck region thereof.
Claim 30
Dependent Claim
18 words
A method as in claim 21 , wherein the method is performed while the patient's heart is beating.
Claim 31
Dependent Claim
20 words
A method as in claim 21 , wherein the method is performed while the patient is under a local anesthetic.
Claim 32
Dependent Claim
37 words
A method as in claim 21 , further comprising separating the parietal pericardium from the visceral pericardium near the left atrial appendage prior to closing the left atrial appendage to create a space over the atrial appendage.
Claim 33
Dependent Claim
16 words
A method as in claim 28 , further comprising viewing the atrial appendage through the space.
Claim 34
Independent Claim
67 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: inserting a closure instrument through a percutaneous passage; introducing the closure instrument into a pericardial space by passing the closure instrument beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, without passing through the pleural space; and closing the left atrial appendage using the closure instrument.
Claim 35
Independent Claim
67 words
A method for closing a left atrial appendage of a patient's heart, said method comprising: inserting a closure instrument through a percutaneous passage; introducing the closure instrument into a pericardial space by passing the closure instrument beneath the rib cage, over an epicardial surface, and adjacent to the left atrial appendage, without passing through the pleural space; and closing the left atrial appendage using the closure instrument.
Claim 36
Dependent Claim
35 words
A method as in claim 30 , wherein inserting comprises making an incision between a costal cartilage and a xiphoid of the patient and placing an access sheath through the incision into the pericardial space.
Claim 37
Dependent Claim
38 words
A method as in claim 31 , wherein introducing further comprises advancing a distal end of the closure instrument through the sheath, into the pericardial space, and over an epicardial surface to an atrioventricular groove of the heart.
Claim 38
Dependent Claim
27 words
A method as in claim 32 , wherein closing comprises looping, suturing, stapling, clipping, riveting, clamping, or fusing the left atrial appendage at a neck region thereof.
Claim 39
Dependent Claim
23 words
A method as in claim 33 , wherein closing further comprises grasping the left atrial appendage prior to closing the neck region thereof.
Claim 40
Dependent Claim
18 words
A method as in claim 30 , wherein the method is performed while the patient's heart is beating.
Claim 41
Dependent Claim
20 words
A method as in claim 35 , wherein the method is performed while both lungs of the patient remain inflated.
Claim 42
Dependent Claim
20 words
A method as in claim 36 , wherein the method is performed while the patient is under a local anesthetic.
Claim 43
Dependent Claim
37 words
A method as in claim 30 , further comprising separating the parietal pericardium from the visceral pericardium near the left atrial appendage prior to closing the left atrial appendage to create a space over the atrial appendage.
Claim 44
Dependent Claim
16 words
A method as in claim 38 , further comprising viewing the atrial appendage through the space.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2005-12-02 | 2006-06-03 | 2006-12-03 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2009-12-02 | 2010-06-03 | 2010-12-03 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2013-12-02 | 2014-06-03 | 2014-12-03 | $7700.00 | Window Closed / Lapsed |