Systems and methods of tissue closure
Apparatus, systems, and methods are described for closing the base of a left atrial appendage or other tissue structure. A tissue closure device comprises a pair of legs having compliant surfaces for engaging against opposite sides of the tissue structure. A plurality of axially spaced-apart tissue-penetrating fasteners are delivered from one leg to the other to pierce the intervening tissue and hold the closure device in place on the tissue structure.
1. A method for closing a tissue structure, said method comprising:
positioning a compression body over the tissue structure with at least two compliant tissue-engaging surfaces engaging opposite sides of the structure;
deploying fasteners from at least one of said surfaces, through the tissue, and into the other surface to close the tissue structure, wherein the fasteners are deployed to close the tissue-engaging surfaces against the tissue with a pressure in the range from 0.25 psi to 20 psi.
2. A method as in claim 1 , wherein the tissue structure is a left atrial appendage.
3. A method as in claim 2 , wherein positioning comprises intercostally advancing the compression member.
4. A method as in claim 2 , wherein positioning comprises carrying the compliant compression body on an applicator, spreading the tissue-engaging surfaces using the applicator, and closing the spread legs over the tissue structure before applying the vacuum.
5. A method as in claim 1 , wherein deploying fasteners comprises advancing male elements from either or both of the tissue-engaging surface(s) to female elements in the opposed tissue-engaging surface.
6. A method as in claim 1 , wherein deploying fasteners comprises advanced barbed needles from one tissue-engaging surface to the other tissue-engaging surface.
7. A method as in claim 1 , further comprising viewing the tissue structure through an optical scope during at least a portion of the procedure.
8. A method as in claim 1 , further comprising directly viewing the tissue structure through a percutaneous opening during at least a portion of the procedure.
9. A method as in claim 1 , further comprising introducing a substrate to the tissue structure through the compression body.
10. A method as in claim 9 , wherein the substance is an antibiotic, an antiseptic, or an anti-inflammatory.
11. A method as in claim 1 , further comprising excising the tissue structure at a location above the compression body after the fasteners have been deployed.
12. A method as in claim 1 , wherein the fasteners do not extend out of the compression body after deployment.
13. A method as in claim 1 , wherein the closed fasteners provide an interrupted attachment that closes the tissue structure.
14. A method for closing a tissue structure, said method comprising the steps of:
positioning a compression body over the tissue structure with at least two compliant tissue-engaging surfaces engaging opposite sides of the structure;
applying a vacuum through the compression body to adhere the surfaces to the tissue structure; and
deploying fasteners from at least one of said surfaces, through the tissue, and into the other surface to close the tissue structure while the vacuum continues to be applied, wherein the fasteners are deployed to close the tissue-engaging surfaces against the tissue with a pressure in the range from 0.25 psi to 20 psi.
15. A method as in claim 14 , wherein curing the pressure is in the range from 0.25 psi to 1.5 psi.
16. A method for closing a tissue structure, said method comprising the steps of:
positioning a compression body over the tissue structure with at least two compliant tissue-engaging surfaces engaging opposite sides of the structure;
applying a vacuum through the compression body to adhere the surfaces to the tissue structure;
deploying fasteners from at least one of said surfaces, through the tissue, and into the other surface to close the tissue structure while the vacuum continues to be applied; and
excising the tissue structure at a location above the compression body after the fasteners have been deployed.