Devices and methods for excluding the left atrial appendage
Devices and methods are described for occluding the left atrial appendage (LAA) to exclude the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. An implant is delivered via transcatheter delivery into the LAA. The implant includes a conformable structure comprising a foam body and internal support. The support includes anchors that penetrate the foam body and anchor the implant to the walls of the LAA. The implant provides compliance such that it conforms to the native configuration of the LAA.
1. A method of excluding a left atrial appendage (LAA), the method comprising:
advancing a guidewire into the LAA;
advancing a distal end of a delivery catheter over the guidewire and into the LAA;
deploying a LAA occlusion device from the distal end of the delivery catheter, wherein the LAA occlusion device includes a foam body and a support structure having an anchor; and
engaging tissue of the LAA with the anchor to secure the LAA occlusion device within the LAA, wherein the anchor penetrates the foam body such that a tip of the anchor is positioned outside the foam body to engage the tissue.
2. The method of claim 1 , wherein the anchor extends along an axis, and the method further comprises advancing the anchor along the axis to engage the tissue.
3. The method of claim 1 , further comprising rotating the anchor to engage the tissue with the anchor.
4. The method of claim 1 , further comprising deploying the anchor from a constrained configuration to a deployed configuration.
5. The method of claim 1 , further comprising:
compressing the LAA occlusion device to a constrained configuration for delivery; and
expanding the LAA occlusion device to a deployed configuration after deploying the LAA occlusion device from the delivery catheter.
6. The method of claim 5 , wherein expanding the LAA occlusion device comprises the LAA occlusion device self-expanding after deploying from the delivery catheter.
7. The method of claim 5 , further comprising restraining the LAA occlusion device with a sheath for delivery.
8. The method of claim 7 , further comprising removing the sheath from the LAA occlusion device.
9. The method of claim 8 , wherein expanding the LAA occlusion device comprises the LAA occlusion device self-expanding after removal of the sheath.
10. The method of claim 1 , further comprising retracting the anchor from engagement with the tissue.
11. The method of claim 10 , further comprising repositioning the LAA occlusion device after retracting the anchor.
12. The method of claim 11 , further comprising re-engaging the tissue with the anchor after repositioning the LAA occlusion device.
13. The method of claim 1 , wherein the LAA occlusion device comprises a plurality of the anchors, and the method further comprises engaging the tissue with the plurality of anchors.
14. The method of claim 13 , wherein the plurality of the anchors penetrate the foam body such that respective tips of the plurality of anchors are positioned outside the foam body to engage the tissue.
15. The method of claim 1 , wherein deploying the LAA occlusion device comprises retracting a sheath distally from around the LAA occlusion device to allow the LAA occlusion device to self-expand.
16. The method of claim 15 , further comprising re-sheathing the LAA occlusion device after expansion of the LAA occlusion device.
17. The method of claim 1 , wherein the foam body comprises a proximal face and a sidewall extending distally from the proximal face.
18. The method of claim 1 , wherein the support structure comprises a central hub and the anchor is connected to the hub via a support segment.
19. The method of claim 1 , wherein the support structure comprises a plurality of struts joined at a distal end to a central hub.
20. The method of claim 1 , wherein a proximal end of the LAA occlusion device faces the left atrium after delivery and comprises a thromboresistant blood-contacting surface.