Device and method of use for functional isolation of animal or human tissues

Abstract

A method and apparatus for functionally occluding the lumen of the left atrial appendage (LAA) is provided. Access to the LAA is through an epicardial approach. The devices function to capture the LAA through various non-invasive means. After capturing the LAA with the devices and methods provided, a clamping device is preferably disposed about the base of the appendage. In certain embodiments, the appendage remains viable subsequent to the functional occlusion of the lumen.

1 . A method of occluding the lumen of the left atrial appendage (LAA) from the left atrium of a patient, comprising:
 accessing the LAA;   capturing the LAA; and   attaching a closure device to the base of the LAA to functionally isolate the lumen of the LAA from the left atrium.   
     
     
         2 . The method according to  claim 1  wherein the step of accessing the LAA comprises epicardial access via an endoscopic port. 
     
     
         3 . The method according to  claim 1  wherein, following the attaching of a closure device to the base of the LAA, the appendage remains viable. 
     
     
         4 . The method according to  claim 1  further comprising dissolution of the closure device. 
     
     
         5 . The method according to  claim 1  wherein the step of capturing the LAA is accomplished without penetrating a surface of the appendage. 
     
     
         6 . The method according the  claim 1  wherein the closure device functionally isolates the lumen of the LAA by applying bilateral pressure to the base of the LAA. 
     
     
         7 . The method according the  claim 1  wherein the closure device functionally isolates the lumen of the LAA by applying circumferential pressure to the base of the LAA. 
     
     
         8 . The method according to  claim 1  wherein the step of capturing the LAA comprises suctioning the LAA into a chamber that substantially encompasses the appendage. 
     
     
         9 . The method according to  claim 2  wherein the epicardial access is achieved via a direct pericardial puncture via a subxiphoid approach. 
     
     
         10 . The method according to  claim 1  wherein the capturing and attaching step are performed by a unitary device. 
     
     
         11 . The method according to  claim 10  wherein the unitary device is an apparatus comprising:
 a capture chamber having an intake port for receiving the LAA, said chamber being of sufficient capacity to enclose the LAA; 
 a snare adapted to isolate the LAA, wherein the snare is disposed outside the capture chamber during the entire operation of the apparatus including before and during isolation of the LAA by the snare, wherein physical integrity of said left atrium is maintained during operation of the apparatus; 
 a cinch adapted to engage the snare, wherein the cinch is disposed outside the capture chamber during operation of the apparatus including before and during isolation of the LAA by the snare; and 
 an actuator proximal to the capture chamber, wherein said actuator is adapted to actuate the cinch to draw the snare closed at the base of the LAA to isolate the LAA, wherein the snare is adapted to disengage from the actuator and remain securely in place at the base of the LAA. 
 
     
     
         12 . A method of performing endoscopic surgery to functionally isolate a target tissue, body lumen or appendage of a patient by restriction of an external surface layer of the tissue, the method comprising:
 visualizing the target tissue;   capturing the target tissue by encompassing at least a portion of the external surface layer; and   disposing a closure device adjacent to a portion of the target tissue to isolate the captured target tissue.   
     
     
         13 . The method according  claim 12  wherein the visualizing step, the capturing step, and the disposing step are accomplished with a unitary medical device. 
     
     
         14 . The method according to  claim 12  wherein the target tissue is the LAA and the closure device prevents the exchange of lumenal contents of the LAA with blood in the left atrium and maintains vascularization of the appendage. 
     
     
         15 . A method of constricting the base of the left atrial appendage (LAA) of a patient to functionally close the oriface between the LAA and the left atrium via epicardial access of the patient's heart, the method comprising the steps of:
 providing an endoscopic device having capture means and deployment means;   accessing the LAA with the device;   capturing the LAA with the capture means; and   deploying closure means from the device to ensnare the base of the LAA.   
     
     
         16 . The method according to  claim 15  wherein the capture means comprises suction immobilization. 
     
     
         17 . The method according to  claim 15  wherein the capturing step comprises aspirating the LAA into a chamber. 
     
     
         18 . The method of  claim 15  further comprising undertaking the steps of accessing, capturing and deploying under local anesthetic. 
     
     
         19 . The method of  claim 15  wherein the steps of accessing, capturing and deploying are performed by a unitary device. 
     
     
         20 . The method according to  claim 15  wherein the closure means constricts the base of the LAA to stop blood flow between the lumen of the LAA and the left atrium while allowing the walls of the LAA to remain viable, 
     
     
         21 . The method according to  claim 20  wherein the closure means subsequently dissolves. 
     
     
         22 . The method according to  claim 15  wherein the closure means are comprised of electrodes, said electrodes capable of transmitting a bipolar radio frequency. 
     
     
         23 . The method according to  claim 15  wherein the capture means comprises non-invasive direct contact with the epicardial surface of the LAA.