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公开(公告)号：US09498223B2
公开(公告)日：2016-11-22
申请号：US12363359
申请日：2009-01-30
CPC分类号： A61B17/12013 , A61B17/0467 , A61B17/0469 , A61B17/12009 , A61B2017/00243 , A61B2017/00867 , A61B2017/00876 , A61B2017/0475 , A61B2017/0477 , A61B2090/3966 , A61M25/10
摘要： Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture.
摘要翻译： 这里描述的是关闭左心耳的装置，系统和方法。 这里描述的一些方法利用具有对准构件的一个或多个引导构件来帮助闭合装置的定位。 通常，这些方法包括将具有第一对准构件的第一引导件推进到左心耳中，将具有第二对准构件的第二引导件推进到心包空间中，使第一和第二对准构件对准，推进左心耳 闭合装置进入心包空间并邻近左心耳，并用闭合装置关闭左心耳。 在这些变型中，闭合装置通常具有细长体，其具有近端和远端，以及至少部分地容纳在细长体内的闭合元件。 闭合元件包括限定连续孔的环。
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公开(公告)号：US09198664B2
公开(公告)日：2015-12-01
申请号：US12752873
申请日：2010-04-01
申请人： Gregory W. Fung , Russell A. Seiber , Eduardo Sager , Gary H. Miller , Maria Garcia , Ryan Douglas Helmuth , Arnold M. Escano , Douglas Todd Ellison , William E. Cohn
发明人： Gregory W. Fung , Russell A. Seiber , Eduardo Sager , Gary H. Miller , Maria Garcia , Ryan Douglas Helmuth , Arnold M. Escano , Douglas Todd Ellison , William E. Cohn
CPC分类号： A61B17/12013 , A61B17/0469 , A61B17/0487 , A61B17/06114 , A61B2017/00243 , A61B2017/003 , A61B2017/00331 , A61B2017/00557 , A61B2017/00867 , A61B2017/0475 , A61B2017/0496 , A61B2017/3445 , A61B2090/037 , A61B2090/0811
摘要： Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.
摘要翻译： 这里描述了用于关闭一个或多个组织的装置，以及用于控制这些装置的手柄。 通常，这里描述的装置包括圈套环组件，其中圈套环组件包括圈套和缝合线环以及用于控制圈套环组件的手柄。 在一些变型中，圈套环组件可以包括保持构件，其可以将缝合线环可释放地连接到圈套。 在其他变型中，装置包括一个或多个减小力的缝合线锁，以帮助防止缝合线环从圈套圈组件中无意中脱离。 在其他变体中，超缝合管理功能。 这里描述的手柄可以被配置为从缝合线环去除多余的缝合线，并且还可以被配置为从缝合环组件释放缝线环。
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公开(公告)号：US08986325B2
公开(公告)日：2015-03-24
申请号：US12363381
申请日：2009-01-30
CPC分类号： A61B17/12013 , A61B17/0467 , A61B17/0469 , A61B17/12009 , A61B2017/00243 , A61B2017/00867 , A61B2017/00876 , A61B2017/0475 , A61B2017/0477 , A61B2090/3966 , A61M25/10
摘要： Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture.
摘要翻译： 这里描述的是关闭左心耳的装置，系统和方法。 这里描述的一些方法利用具有对准构件的一个或多个引导构件来帮助闭合装置的定位。 通常，这些方法包括将具有第一对准构件的第一引导件推进到左心耳中，将具有第二对准构件的第二引导件推进到心包空间中，使第一和第二对准构件对准，推进左心耳 闭合装置进入心包空间并邻近左心耳，并用闭合装置关闭左心耳。 在这些变型中，闭合装置通常具有细长体，其具有近端和远端，以及至少部分地容纳在细长体内的闭合元件。 闭合元件包括限定连续孔的环。
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公开(公告)号：US08771297B2
公开(公告)日：2014-07-08
申请号：US12055213
申请日：2008-03-25
IPC分类号： A61B17/00
CPC分类号： A61B17/12013 , A61B17/0467 , A61B17/0469 , A61B17/12009 , A61B2017/00243 , A61B2017/00867 , A61B2017/00876 , A61B2017/0475 , A61B2017/0477 , A61B2090/3966 , A61M25/10
摘要： Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture.
摘要翻译： 这里描述的是关闭左心耳的装置，系统和方法。 这里描述的一些方法利用具有对准构件的一个或多个引导构件来帮助闭合装置的定位。 通常，这些方法包括将具有第一对准构件的第一引导件推进到左心耳中，将具有第二对准构件的第二引导件推进到心包空间中，使第一和第二对准构件对准，推进左心耳 闭合装置进入心包空间并邻近左心耳，并用闭合装置关闭左心耳。 在这些变型中，闭合装置通常具有细长体，其具有近端和远端，以及至少部分地容纳在细长体内的闭合元件。 闭合元件包括限定连续孔的环。
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5.发明申请DEVICES, SYSTEMS, AND METHODS FOR CLOSING THE LEFT ATRIAL APPENDAGE 有权用于关闭左侧ATRIAL APPENDAGE的设备，系统和方法公开(公告)号：US20090157118A1
公开(公告)日：2009-06-18
申请号：US12363359
申请日：2009-01-30
CPC分类号： A61B17/12013 , A61B17/0467 , A61B17/0469 , A61B17/12009 , A61B2017/00243 , A61B2017/00867 , A61B2017/00876 , A61B2017/0475 , A61B2017/0477 , A61B2090/3966 , A61M25/10
摘要： Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.
摘要翻译： 这里描述的是关闭左心耳的装置，系统和方法。 这里描述的一些方法利用具有对准构件的一个或多个引导构件来帮助闭合装置的定位。 通常，这些方法包括将具有第一对准构件的第一引导件推进到左心耳中，将具有第二对准构件的第二引导件推进到心包空间中，使第一和第二对准构件对准，推进左心耳 闭合装置进入心包空间并邻近左心耳，并用闭合装置关闭左心耳。 在这些变型中，闭合装置通常具有细长体，其具有近端和远端，以及至少部分地容纳在细长体内的闭合元件。 闭合元件包括限定穿过其中的连续孔的环。
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公开(公告)号：US20090082797A1
公开(公告)日：2009-03-26
申请号：US12212511
申请日：2008-09-17
IPC分类号： A61B17/32
CPC分类号： A61B17/0482 , A61B17/0467 , A61B17/0469 , A61B2017/00367 , A61B2017/00557 , A61B2017/00876 , A61B2090/034
摘要： Described here are devices and methods for suture management. In some variations, the devices comprise an elongate tubular member having a proximal end, a distal end, a lumen therebetween, a cantilever blade positioned near the distal end of the elongate tubular member, and an expandable member positioned adjacent the cantilever blade for actuating the cantilever blade. Also described are devices comprising an elongate tubular member having a proximal end, a distal end, a lumen at least partially therebetween, and an aperture in a wall thereof for passage of a suture therethrough. These devices further comprise a blade connected to a blade housing disposed within the lumen, where the blade is oriented parallel to the longitudinal axis of the lumen. The blade and blade housing may be slidable within the lumen, or an inner shaft for may be slidable within the lumen. Methods of using the devices are also described.
摘要翻译： 这里描述的是缝合线管理的装置和方法。 在一些变型中，装置包括细长的管状构件，其具有近端，远端，其间的内腔，位于细长管状构件的远端附近的悬臂刀片，以及邻近悬臂刀片定位的可扩张构件，用于致动 悬臂刀片。 还描述了包括细长管状构件的装置，该细长管状构件具有近端，远端，至少部分在其间的腔，以及其壁中的孔，用于通过缝合线。 这些装置还包括连接到设置在内腔内的刀片壳体的刀片，其中刀片平行于管腔的纵向轴线定向。 刀片和刀片壳体可以在内腔内滑动，或者可以在内腔内滑动的内轴。 还描述了使用装置的方法。
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公开(公告)号：US08469983B2
公开(公告)日：2013-06-25
申请号：US12212511
申请日：2008-09-17
IPC分类号： A61B17/138
CPC分类号： A61B17/0482 , A61B17/0467 , A61B17/0469 , A61B2017/00367 , A61B2017/00557 , A61B2017/00876 , A61B2090/034
摘要： Described here are devices and methods for suture management. In some variations, the devices comprise an elongate tubular member having a proximal end, a distal end, a lumen therebetween, a cantilever blade positioned near the distal end of the elongate tubular member, and an expandable member positioned adjacent the cantilever blade for actuating the cantilever blade. Also described are devices comprising an elongate tubular member having a proximal end, a distal end, a lumen at least partially therebetween, and an aperture in a wall thereof for passage of a suture therethrough. These devices further comprise a blade connected to a blade housing disposed within the lumen, where the blade is oriented parallel to the longitudinal axis of the lumen. The blade and blade housing may be slidable within the lumen, or an inner shaft for may be slidable within the lumen. Methods of using the devices are also described.
摘要翻译： 这里描述的是缝合线管理的装置和方法。 在一些变型中，装置包括细长的管状构件，其具有近端，远端，其间的内腔，位于细长管状构件的远端附近的悬臂刀片，以及邻近悬臂刀片定位的可扩张构件，用于致动 悬臂刀片。 还描述了包括细长管状构件的装置，该细长管状构件具有近端，远端，至少部分在其间的腔，以及其壁中的孔，用于通过缝合线。 这些装置还包括连接到设置在内腔内的刀片壳体的刀片，其中刀片平行于管腔的纵向轴线定向。 刀片和刀片壳体可以在内腔内滑动，或者可以在内腔内滑动的内轴。 还描述了使用装置的方法。
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公开(公告)号：US20110087247A1
公开(公告)日：2011-04-14
申请号：US12752873
申请日：2010-04-01
申请人： Gregory W. Fung , Russell A. Seiber , Eduardo Sager , Gary H. Miller , Maria Garcia , Ryan Douglas Helmuth , Arnold M. Escano , Douglas Todd Ellison , William E. Cohn
发明人： Gregory W. Fung , Russell A. Seiber , Eduardo Sager , Gary H. Miller , Maria Garcia , Ryan Douglas Helmuth , Arnold M. Escano , Douglas Todd Ellison , William E. Cohn
IPC分类号： A61B17/04
CPC分类号： A61B17/12013 , A61B17/0469 , A61B17/0487 , A61B17/06114 , A61B2017/00243 , A61B2017/003 , A61B2017/00331 , A61B2017/00557 , A61B2017/00867 , A61B2017/0475 , A61B2017/0496 , A61B2017/3445 , A61B2090/037 , A61B2090/0811
摘要： Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.
摘要翻译： 这里描述了用于关闭一个或多个组织的装置，以及用于控制这些装置的手柄。 通常，这里描述的装置包括圈套环组件，其中圈套环组件包括圈套和缝合线环以及用于控制圈套环组件的手柄。 在一些变型中，圈套环组件可以包括保持构件，其可以将缝合线环可释放地连接到圈套。 在其他变型中，装置包括一个或多个减小力的缝合线锁，以帮助防止缝合线环从圈套圈组件中无意中脱离。 在其他变体中，超缝合管理功能。 这里描述的手柄可以被配置为从缝合线环去除多余的缝合线，并且还可以被配置为从缝合环组件释放缝线环。
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9.发明申请DEVICES, SYSTEMS, AND METHODS FOR CLOSING THE LEFT ATRIAL APPENDAGE 有权用于关闭左侧ATRIAL APPENDAGE的设备，系统和方法公开(公告)号：US20080243183A1
公开(公告)日：2008-10-02
申请号：US12055213
申请日：2008-03-25
IPC分类号： A61B17/04
CPC分类号： A61B17/12013 , A61B17/0467 , A61B17/0469 , A61B17/12009 , A61B2017/00243 , A61B2017/00867 , A61B2017/00876 , A61B2017/0475 , A61B2017/0477 , A61B2090/3966 , A61M25/10
摘要： Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.
摘要翻译： 这里描述的是关闭左心耳的装置，系统和方法。 这里描述的一些方法利用具有对准构件的一个或多个引导构件来帮助闭合装置的定位。 通常，这些方法包括将具有第一对准构件的第一引导件推进到左心耳中，将具有第二对准构件的第二引导件推进到心包空间中，使第一和第二对准构件对准，推进左心耳 闭合装置进入心包空间并邻近左心耳，并用闭合装置关闭左心耳。 在这些变型中，闭合装置通常具有细长体，其具有近端和远端，以及至少部分地容纳在细长体内的闭合元件。 闭合元件包括限定穿过其中的连续孔的环。
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公开(公告)号：US08795310B2
公开(公告)日：2014-08-05
申请号：US13086390
申请日：2011-04-13
IPC分类号： A61B17/34
CPC分类号： A61B18/1492 , A61B17/12013 , A61B17/12122 , A61B17/12131 , A61B17/12136 , A61B17/12172 , A61B17/12195 , A61B17/122 , A61B18/02 , A61B18/1815 , A61B18/24 , A61B2017/00084 , A61B2017/00243 , A61B2017/00247 , A61B2017/00477 , A61B2017/00876 , A61B2018/00279 , A61B2018/00357 , A61B2018/00363 , A61B2018/00791 , A61B2018/0212 , A61B2018/1407 , A61B2018/1861 , A61F2/24 , A61F2/2427 , A61F2/2442 , A61M25/0127 , A61N7/00 , A61N7/02 , A61N7/022
摘要： Described here are devices, methods, and systems for accessing and delivering devices to a heart. The left atrial appendage may be used as an access port to allow pericardial access to internal structures of the heart. Systems that may be used to provide access to the heart via the left atrial appendage may comprise a first access element with a first alignment member, a second access element with a second alignment member, a piercing element, and an exchange element. Some systems may further comprise a left atrial appendage stabilization device. Methods of accessing and delivering devices to the heart via the left atrial appendage may comprise advancing a first access element into the left atrial appendage by an intravascular pathway and advancing a second access element towards the left atrial appendage through the pericardial space. The first and second alignment members may form an attachment through the wall of the left atrial appendage so that the first and second access elements are aligned. A piercing element may be advanced to pierce the wall of the left atrial appendage to form an access site therethrough. Optionally, an exchange element may be advanced to initiate a track between the inside and outside of the left atrial appendage, which may be used for device delivery. Also described here are various methods and devices to create a left atrial appendage access site to help position and operate devices within the heart.
摘要翻译： 这里描述的是用于访问和传送设备到心脏的设备，方法和系统。 左心耳可用作进入口，以允许心包进入心脏的内部结构。 可以用于通过左心耳提供对心脏的接近的系统可以包括具有第一对准构件的第一存取元件，具有第二对准构件的第二存取元件，穿孔元件和交换元件。 一些系统还可以包括左心耳稳定装置。 通过左心耳进入和传送装置的方法可以包括通过血管内途径将第一进入元件推进到左心耳内，并通过心包空间向第二进入元件推进向左心耳。 第一和第二对准构件可以通过左心耳的壁形成附件，使得第一和第二访问元件对准。 穿刺元件可以被推进以刺穿左心耳的壁以形成通过其的通道。 可选地，交换元件可以被提前以在左心耳的内部和外部之间启动轨迹，该轨迹可用于装置递送。 这里还描述了用于创建左心耳访问站点以帮助在心脏内定位和操作设备的各种方法和装置。
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