DEVICE ALLOWING LARGE BORE TRANSSEPTAL ACCESS WITH SUBSEQUENT ATRIAL RE-ACCESS AND METHOD THEREOF
The present disclosure relates to medical devices. More particularly, this disclosure describes a vascular device allowing large bore transseptal access with subsequent atrial re-access by preplacing closures/tissue approximating sutures prior to creating a septostomy. Generally, the device may include a delivery catheter for puncturing and cutting the interatrial septum. An anchor of the delivery catheter may secure the suture in an atrium to a septum wall, for example, the left atrium. Incisions may be made by an expandable cutting implement which may use mechanical or radio frequency (RF) energy without interfering with the suture. A therapeutic instrument may be advanced through the tissue plane after the incisions are made by the cutting implement. Closure of the incision may be performed with the previously placed sutures.
1 . A vascular device for performing a transseptal puncture, comprising:
a body;
an anchor extending from a distal end of the body through a shaft disposed within the body;
at least one suture coupled to at least one needle within the anchor;
at least one catch extending from the body to pull the at least one needle into the body for placing the at least one suture; and
a cutting implement between the body and anchor coupled to an actuating shaft aligned with the at least one suture.
2 . The vascular device for performing the transseptal puncture of claim 1 , comprising a guidewire disposed within the body and anchor.
3 . The vascular device for performing the transseptal puncture of claim 1 , wherein a face of the body and anchor are angled.
4 . The vascular device for performing the transseptal puncture of claim 1 , wherein the body comprises a rectangular-shaped lumen for the shaft of the anchor.
5 . The vascular device for performing the transseptal puncture of claim 1 , wherein the body comprises at least one lumen for the at least one catch.
6 . The vascular device for performing the transseptal puncture of claim 1 , wherein the at least one suture is stored in a recess channel of the anchor.
7 . The vascular device for performing the transseptal puncture of claim 6 , wherein the at least one suture comprises two ends coupled to two needles extending towards the body.
8 . The vascular device for performing the transseptal puncture of claim 6 , wherein the recess channel releases the at least one suture after pulled by the at least one catch.
9 . The vascular device for performing the transseptal puncture of claim 1 , wherein the device comprises two sutures with each suture coupled to two needles.
10 . The vascular device for performing the transseptal puncture of claim 1 , wherein the at least one catch is pulled from a proximal end of the body.
11 . The vascular device for performing the transseptal puncture of claim 1 , wherein the actuating shaft of the cutting implement telescopes over the shaft of the anchor.
12 . The vascular device for performing the transseptal puncture of claim 1 , wherein the cutting implement is expanded radially from the body through the actuating shaft.
13 . The vascular device for performing the transseptal puncture of claim 12 , wherein the actuating shaft causes the cutting implement to bow at a greater length than a diameter of the body.
14 . The vascular device for performing the transseptal puncture of claim 12 , wherein the actuating shaft causes a linkage system to expand the cutting implement.
15 . The vascular device for performing the transseptal puncture of claim 1 , wherein the cutting implement uses mechanical or electrical energy.
16 . The vascular device for performing the transseptal puncture of claim 15 , wherein the mechanical or electrical energy comes from at least one of a blade, ceramic, electrocautery technique, radio frequency, plasmajet vaporization, ultra-sonic, high voltage vaporization, controlled dilation, heat and cold.
17 . A septal orifice closure apparatus allowing re-access, comprising:
a body on a first side of a septal orifice in a septum of a heart;
an anchor on a second side of the septal orifice extending from a distal end of the body through a shaft disposed within the body;
at least one suture coupled to at least one needle disposed within the anchor;
at least one catch extending from the body to pull the at least one needle into the body for placing the at least one suture; and
a cutting implement between the body and anchor coupled to an actuating shaft aligned with the at least one suture.
18 . The septal orifice closure apparatus of claim 17 , wherein the cutting implement uses mechanical or electrical energy.
19 . The septal orifice closure apparatus of claim 17 , comprising a guidewire disposed within the body.
20 . The septal orifice closure apparatus of claim 17 , wherein the cutting implement comprises a first circuit for a first puncture and a second circuit for a larger cut.