Left atrial appendage manipulation
A method for closure of the left atrial appendage (LAA), including: placing an LAA reshaper in contact with an LAA wall or near the LAA wall; invaginating at least a portion of the LAA into the left atrium (LA); reshaping by the LAA reshaper the LAA during the invagination; fastening the invaginated at least a portion of said LAA; and retracting the LAA reshaper from the LAA.
1 . A method for closure of a left atrial appendage (LAA), comprising:
placing in an expanded state, an expandable LAA reshaper having openings in an external side surface, at least partly inside said LAA, and in contact with an LAA wall or near said LAA wall;
applying vacuum on said LAA from a vacuum inlet in a left atrium (LA) outside the LAA, via said expandable LAA reshaper and said openings with a force sufficient to attach an LAA wall surrounding said expandable LAA reshaper to said external side surface of said expandable LAA reshaper;
reshaping said LAA by applying force by said expandable LAA reshaper on said LAA wall from within said LAA while applying said vacuum;
closing an opening of said LAA while said LAA is reshaped following said reshaping and said applying vacuum.
2 . A method according to claim 1 , comprising extending a suction channel terminating with said vacuum inlet into said LA, and placing said vacuum inlet in contact with an LA wall surrounding or near an opening of said LAA, prior to said applying.
3 . A method according to claim 1 , wherein said applying vacuum comprising applying said vacuum with a force sufficient to at least partly inwardly collapse said LAA onto said expandable LAA reshaper.
4 . A method according to claim 1 , wherein said placing comprises expanding said expandable LAA reshaper at least partly within the LAA, and wherein said reshaping comprises applying force by said expanded expandable LAA reshaper on said LAA wall from within said LAA.
5 . A method according to claim 4 , comprising retracting said expandable LAA reshaper into said LA while applying said force.
6 . A method according to claim 5 , comprising applying said vacuum on said LAA during said retracting.
7 . A method according to claim 6 , wherein said applied vacuum comprises high pressure vacuum in a range of 400-900 mmHg.
8 . A method according to claim 1 , wherein said placing comprises inserting said expandable LAA reshaper up to 30 mm into said LAA.
9 . A method according to claim 1 , comprising reshaping by said expandable LAA reshaper the LAA during invagination of said LAA.
10 . A method according to claim 1 , comprising:
invaginating during said applying vacuum and while retracting said expandable LAA reshaper into said LA, at least a portion of said LAA into the LA;
removing said expandable LAA reshaper from the LAA;
wherein said closing comprises fastening said invaginated at least a portion of said LAA.
11 . A method according to claim 1 , wherein said expandable LAA reshaper comprises a distal expandable portion, wherein said openings are openings in an external side surface of said distal expandable portion, and wherein said placing comprises placing said distal expandable portion in said expanded state at least partly inside said LAA.
12 . A method according to claim 1 , wherein said closing comprises fastening at least a portion of said LAA.
13 . A method according to claim 1 , comprising anchoring said expandable LAA reshaper to said LAA wall.
14 . A method according to claim 1 , wherein said reshaping comprises reshaping during said applying vacuum said LAA, by applying force from within said LAA by said expandable LAA reshaper on said LAA wall in contact with said external side surface of said expandable LAA reshaper, wherein said reshaping comprises moving said LAA reshaper within said LAA while applying said force on said LAA wall.