Centered balloon for the left atrial appendage

Abstract

A medical device for reducing the volume of a left atrial appendage (LAA) may include an elongate shaft having a distal portion, and a volume-reducing means expandable from a collapsed to an expanded state, the volume-reducing means being releasably attached to the distal portion. The volume-reducing means may include an actuatable frame and an impermeable covering disposed over the frame. The volume-reducing means may be sized to fit within the LAA in the expanded state while maintaining an open fluid flow path from a distal region through the ostium of the LAA. A medical device may include a second volume-reducing means to be placed within and substantially occlude a distalmost region of the LAA. A method may include inserting a volume-reducing means into the LAA, expanding the volume-reducing means, and positioning the volume-reducing means such that an open fluid flow path is maintained through an entire cycle of the heart.

We claim: 
     
         1 . A medical device for reducing the volume of a left atrial appendage of a heart, the left atrial appendage having a generally longitudinal axis, a lateral wall, and an ostium forming a proximal mouth thereof, comprising:
 an elongate shaft having a distal portion; and   a volume-reducing means expandable from a collapsed state to an expanded state, the volume-reducing means being releasably attached to the distal portion;   wherein the volume-reducing means includes an actuatable support frame and an impermeable covering disposed over the support frame;   wherein the volume-reducing means is sized to fit within the left atrial appendage in the expanded state while maintaining an open fluid flow path from a distal region of the left atrial appendage through the ostium of the left atrial appendage.   
     
     
         2 . The medical device of  claim 1 , wherein the volume-reducing means is sized to reduce the volume of the left atrial appendage by at least 40%. 
     
     
         3 . The medical device of  claim 2 , wherein the volume-reducing means is sized to reduce the volume of the left atrial appendage by at least 65%. 
     
     
         4 . The medical device of  claim 3 , wherein the volume-reducing means is sized to reduce the volume of the left atrial appendage by at least 90%. 
     
     
         5 . The medical device of  claim 1 , wherein the volume-reducing means further includes an anchoring means configured to engage the lateral wall of the left atrial appendage. 
     
     
         6 . The medical device of  claim 5 , wherein the anchoring means includes a plurality of anchoring members extending outwardly from an outer surface of the volume-reducing means. 
     
     
         7 . The medical device of  claim 6 , wherein the plurality of anchoring members each include a means of limiting penetration of the plurality of anchoring members into the lateral wall of the left atrial appendage. 
     
     
         8 . The medical device of  claim 6 , wherein the plurality of anchoring members maintain the volume-reducing means in a spaced-apart relationship with the lateral wall of the left atrial appendage. 
     
     
         9 . The medical device of  claim 1 , wherein the elongate shaft includes an inflation lumen in fluid communication with an interior of the volume-reducing means. 
     
     
         10 . The medical device of  claim 9 , wherein the volume-reducing means includes a means of introducing an inflation medium into the interior of the volume-reducing means while preventing the inflation medium from exiting the interior of the volume-reducing means. 
     
     
         11 . The medical device of  claim 10 , wherein the inflation medium is a fluid. 
     
     
         12 . The medical device of  claim 10 , wherein the inflation medium is configured to at least partially solidify within the interior of the volume-reducing means. 
     
     
         13 . The medical device of  claim 1 , wherein the open fluid flow path is disposed between an outer surface of the volume-reducing means and the lateral wall of the left atrial appendage. 
     
     
         14 . The medical device of  claim 1 , wherein the volume-reducing means is configured to maintain the open fluid flow path during an entire cycle of the heart. 
     
     
         15 . The medical device of  claim 1 , wherein the volume-reducing means is configured to be disposed within a distalmost region of the left atrial appendage. 
     
     
         16 . The medical device of  claim 15 , wherein the volume-reducing means substantially occludes the distalmost region of the left atrial appendage. 
     
     
         17 . A medical device for reducing the volume of a left atrial appendage of a heart, the left atrial appendage having a generally longitudinal axis, a lateral wall, and an ostium forming a proximal mouth thereof, comprising:
 an elongate shaft having a distal portion;   a first volume-reducing means expandable from a collapsed state to an expanded state, the first volume-reducing means being releasably attached to the distal portion; and   a second volume-reducing means expandable from a collapsed state to an expanded state, the second volume reducing means being releasably attached to the distal portion;   wherein the first volume-reducing means and the second volume-reducing means each include an actuatable support frame and an impermeable covering disposed over the support frame;   wherein the first volume-reducing means is sized to fit within the left atrial appendage in the expanded state while maintaining an open fluid flow path from a distal region of the left atrial appendage through the ostium of the left atrial appendage;   wherein the second volume-reducing means is configured to be placed within and substantially occlude a distalmost region of the left atrial appendage.   
     
     
         18 . The medical device of  claim 17 , wherein the first volume-reducing means and the second volume-reducing means are fixedly attached to each other. 
     
     
         19 . The medical device of  claim 17 , wherein the first volume-reducing means further includes an anchoring means configured to engage the lateral wall of the left atrial appendage. 
     
     
         20 . The medical device of  claim 19 , wherein the anchoring means includes a plurality of anchoring members extending outwardly from an outer surface of the volume-reducing means.