Devices, systems and methods for closure of cardiac openings
The invention generally relates to devices, systems, and methods for percutaneous closure of cardiac openings and obliteration of the cardiac cul-de-sacs. In one embodiment, a closure device includes a patch with an adhesive and/or a removable frame. The patch may be placed across a cardiac opening, such as a patent foramen ovale, or across a cardiac cul-de-sac, such as a left atrial appendage. In another embodiment, a closure device includes a balloon together with adhesives and/or substances for stimulating tissue growth coated on, or contained within, the balloon. The balloon may be inserted into a cardiac opening, such as the patent foramen ovale, or into a cardiac cul-de-sac, such as a left atrial appendage.
1. A method for closing a patent foramen ovale in a patient, comprising:
inserting a system for closing the patent foramen ovale into a heart of the patient via a percutaneous, transluminal procedure, the system comprising:
a first catheter comprising a proximal end, a distal end, and a lumen extending from the proximal end to the distal end;
a second catheter comprising a distal end, wherein the second catheter is movable between a retracted state where the distal end of the second catheter is enclosed within the lumen of the first catheter, and a deployed state where the distal end of the second catheter is extended beyond the distal end of the first catheter;
a lining coupled to the distal end of the first catheter and the distal end of the second catheter, wherein the lining is positioned within the lumen of the first catheter when the second catheter is in the retracted state, and wherein the lining is inverted and is positioned outside the lumen of the first catheter when the second catheter is in the deployed state; and
an adhesive material releasably sealed within the lining;
positioning the system with the distal end of the first catheter proximate the right atrial side opening of the patent foramen ovale with the second catheter in the retracted state;
inverting the lining into the patent foramen, by deploying the second catheter, thereby extending the distal end of the second catheter beyond the distal end of the first catheter;
applying the adhesive to tissues of the patient in the patent foramen ovale by contacting the tissues with the inverted liner, wherein deploying the second catheter causes the adhesive to be released from the lining and exposed to the tissues of the patient;
retracting the lining from the patent foramen ovale; and
withdrawing the system from the patient.
2. The method of claim 1 , wherein the lining comprises a plurality of holes or cavities comprising the adhesive.
3. The method of claim 1 , wherein the lining further comprises a surface coating of adhesive.
4. The method of claim 1 , wherein the lining is a balloon.
5. The method of claim 1 , wherein the adhesive comprises a plurality of particles disposed within the adhesive that expand upon contact with blood or water.
6. The method of claim 5 , wherein the particles are selected from the group consisting of gelatin particles, biological particles, bioresorbable particles, and foam particles.
7. The method of claim 1 , wherein the adhesive is selected from the group of adhesives consisting of cyanoacrylates, fibrin based adhesives, albumin gluteraldehyde adhesives, and light activated adhesives.
8. The method of claim 1 , wherein the adhesive comprises a substance for stimulating tissue growth.
9. The method of claim 8 , wherein the substance for stimulating tissue growth is selected from the group consisting of growth factors, pharmacological agents for stimulating tissue growth, irritants for encouraging an inflammatory response, cells, and genes.