Left atrial appendage closure device with passive fixation

1 . An occlusive medical implant for implantation within a left atrial appendage, comprising:

an expandable framework configured to self-expand from a collapsed configuration to an expanded configuration;

an occlusive element disposed on a proximal portion of the expandable framework;

a distal hub fixedly attached to a distal end of the expandable framework, the distal hub including a central aperture; and

a distal beam extending proximally from the distal hub within an interior of the expandable framework, the distal beam including a distal neck extending through the central aperture of the distal hub to a distal flange disposed distal of a distalmost surface of the distal hub, the distal flange having a radial extent greater than a diameter of the central aperture;

wherein the distal neck is configured to rotate within the central aperture without transferring rotation to the distal hub;

wherein at least a portion of the expandable framework is mechanically expandable from the expanded configuration to a securement configuration;

wherein when the occlusive medical implant is disposed within the left atrial appendage, the expandable framework exerts a first radial force on the left atrial appendage in the expanded configuration and the expandable framework exerts a second radial force on the left atrial appendage in the securement configuration;

wherein the second radial force is greater than the first radial force;

wherein rotation of the distal beam relative to the distal hub changes an axial position of the distal hub relative to the proximal hub.

2 . The occlusive medical implant of claim 1 , further comprising:

a proximal hub fixedly attached to a proximal end of the expandable framework; and

a proximal beam extending distally from the proximal hub within an interior of the expandable framework;

wherein the distal beam is engaged with the proximal beam.

3 . The occlusive medical implant of claim 2 , wherein the distal beam is axially movable relative to the proximal beam.

4 . The occlusive medical implant of claim 2 , wherein the proximal beam is fixedly attached to the proximal hub.

5 . The occlusive medical implant of claim 4 , wherein the distal beam is rotatable relative to the proximal beam.

6 . The occlusive medical implant of claim 1 , further including a second occlusive element disposed on a distal portion of the expandable framework, wherein:

a thickness of the second occlusive element is greater than a thickness of the occlusive element; or

a surface roughness of the second occlusive element is greater than a surface roughness of the occlusive element; or

a coefficient of friction between the second occlusive element and the left atrial appendage is greater than a coefficient of friction between the occlusive element and the left atrial appendage; or

a porosity of the second occlusive element is greater than a porosity of the occlusive element.

7 . A medical device system, comprising:

a catheter having a lumen extending from a proximal opening to a distal opening;

a core wire slidably disposed within the lumen; and

an occlusive medical implant for implantation within a left atrial appendage releasably attached at a distal end of the core wire, the occlusive medical implant comprising:

an expandable framework configured to self-expand from a collapsed configuration to an expanded configuration when unconstrained by the catheter; and

an occlusive element disposed over at least a portion of the expandable framework;

a distal hub fixedly attached to a distal end of the expandable framework, the distal hub including a central aperture; and

a distal beam extending proximally from the distal hub within an interior of the expandable framework, the distal beam including a distal neck extending through the central aperture of the distal hub to a distal flange disposed distal of a distalmost surface of the distal hub, the distal flange having a radial extent greater than a diameter of the central aperture;

wherein the distal neck is configured to rotate within the central aperture without transferring rotation to the distal hub;

wherein at least a portion of the expandable framework is mechanically expandable from the expanded configuration to a securement configuration;

wherein when the occlusive medical implant is disposed within the left atrial appendage, the expandable framework exerts a first radial force on the left atrial appendage in the expanded configuration and the expandable framework exerts a second radial force on the left atrial appendage in the securement configuration;

wherein the second radial force is greater than the first radial force.

8 . The medical device system of claim 7 , wherein the core wire is rotatable relative to the occlusive medical implant.

9 . The medical device system of claim 7 , wherein the expandable framework is devoid of radially protruding anchor elements.

10 . An occlusive medical implant for implantation within a left atrial appendage, comprising:

an expandable framework configured to self-expand from a collapsed configuration to an expanded configuration; and

an occlusive element disposed on a proximal portion of the expandable framework;

a distal hub fixedly attached to a distal end of the expandable framework, the distal hub including a central aperture; and

a distal beam extending proximally from the distal hub within an interior of the expandable framework, the distal beam including a distal neck extending through the central aperture of the distal hub to a distal flange disposed distal of a distalmost surface of the distal hub, the distal flange having a radial extent greater than a diameter of the central aperture;

wherein the distal neck is configured to rotate within the central aperture without transferring rotation to the distal hub;

wherein at least a portion of the expandable framework is mechanically expandable from the expanded configuration to a securement configuration;

wherein the expandable framework has a first radialmost outer extent in the expanded configuration and a second radialmost outer extent in the securement configuration;

wherein the second radialmost outer extent is greater than the first radialmost outer extent;

wherein rotation of the distal beam is configured to shift the expandable framework from the expanded configuration to the securement configuration.