Apparatus and method for the ligation of tissue
A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.
1. A kit comprising:
first and second alignment members, wherein the first and second alignment members are configured to align with one another, wherein the second alignment member has a size and a length adapted for accessing the pericardial space and the first member has a size and a length adapted for accessing the left atrial appendage through the vasculature, and wherein the first alignment member comprises a guidewire and a guide catheter comprising a lumen and a balloon, and wherein the guidewire is slidably positioned through the lumen of the guide catheter; and
a closure device comprising an elongate body comprising a lumen therethrough, a suture loop releasably attached to an expandable structure moveable between a first low-profile configuration and a second expanded configuration, wherein the expandable structure is at least partially within the lumen in the first low-profile configuration and wherein advancement of the expandable structure to the second expanded configuration holds the suture loop in a configuration for placement around the left atrial appendage, and wherein the second alignment member is slidably positioned through the lumen of the elongate body.
2. The kit of claim 1 , wherein the first and second alignment members comprise magnets.
3. The kit of claim 1 , wherein the first and second alignment members comprise electromagnets.
4. The kit of claim 1 , wherein the guide catheter is attached to the first alignment member.
5. The kit of claim 1 , wherein the closure device comprises a delivery catheter.
6. The kit of claim 5 , wherein the expandable structure is bell-shaped when expanded.
7. The kit of claim 5 , wherein the expandable structure is self-expandable.
8. The kit of claim 5 , wherein the expandable structure comprises expandable arms.
9. The kit of claim 8 , wherein the expandable arms comprise springs.
10. The kit of claim 1 , wherein the suture loop comprises polypropylene or PTFE.
11. The kit of claim 1 , wherein the closure device comprises a suction tube.
12. The kit of claim 1 , wherein the first and second alignment members comprise radio-opaque materials.