Tissue capture and occlusion systems and methods

Abstract

Systems and methods capture and/or occlusion of selected body tissue using various tissue characteristics and/or techniques are described. In the context of left atrial appendage closure, the systems and methods can be used to capture the left atrial appendage while a closure instrument (suture, clip, ring, etc.) is placed over the appendage and tightened down or a closure method (ablation, cryogenic procedures, stapling, etc.) is performed to close the left atrial appendage.

1 - 67 . (canceled) 
     
     
         68 . A tissue capture system comprising:
 a capture device configured to capture body tissue;   a capture shaft comprising an elongated body comprising a proximal end and a distal end, wherein the distal end of the capture shaft is coupled to the capture device;   a capture device electrode coupled to the capture device;   a ligation element comprising a loop, wherein the ligation element is configured to ligate the body tissue by tightening of the loop around the body tissue;   a ligation element electrode coupled to the ligation element; and   electrical monitoring apparatus operably coupled to the capture device and the ligation element electrode, wherein the electrical monitoring apparatus is configured to:   monitor an impedance between the capture device electrode and the ligation element electrode; and   determine whether the capture device has captured atrial tissue based on the monitored impedance.   
     
     
         69 . A system according to  claim 68 , wherein the capture device comprises a first jaw and a second jaw, wherein the first jaw and the second jaw comprise an open configuration in which the first jaw and the second jaw are open and a closed configuration in which the first jaw and the second jaw are closed, wherein an interior surface of the first jaw is located closer to an interior surface of the second jaw when the first jaw and the second jaw are in the closed configuration than when the first jaw and the second jaw are in the open configuration, and wherein the capture device electrode is coupled to the interior surface of one of the first jaw and the second jaw. 
     
     
         70 . A system according to  claim 68 , wherein the capture device comprises a first jaw and a second jaw, wherein the first jaw and the second jaw comprise an open configuration in which the first jaw and the second jaw are open and a closed configuration in which the first jaw and the second jaw are closed, wherein an interior surface of the first jaw is located closer to an interior surface of the second jaw when the first jaw and the second jaw are in the closed configuration than when the first jaw and the second jaw are in the open configuration, and wherein the capture device electrode is coupled to the interior surface of the first jaw and wherein the interior surface of the second jaw is free of any electrodes. 
     
     
         71 . A system according to  claim 68 , wherein the system further comprises force-limiting apparatus operably coupled to the capture device to restrict the amount of force applied by the capture device, wherein the electrical monitoring apparatus is further operably coupled to the force-limiting apparatus and is further configured to use the force-limiting apparatus to restrict the amount of force applied by capture device based on the monitored impedance. 
     
     
         72 . A system according to  claim 68 , wherein the system further comprises force-limiting apparatus operably coupled to the ligation element to restrict the amount of force applied by ligation element when the ligation element is tightened around the body tissue, wherein the electrical monitoring apparatus is further operably coupled to the force-limiting apparatus and is further configured to use the force-limiting apparatus to restrict the amount of force applied by the ligation element when the ligation element is tightened around the body tissue based on the monitored impedance. 
     
     
         73 . A system according to  claim 68 , wherein the electrical monitoring apparatus is further configured to provide an indication to a user to restrict the amount of force applied by the capture device based on the monitored impedance. 
     
     
         74 . A system according to  claim 68 , wherein the electrical monitoring apparatus is configured to monitor the impedance between the capture device electrode and the ligation element electrode by monitoring the impedance at a selected frequency between the capture device electrode and the ligation element electrode 
     
     
         75 . A system according to  claim 68 , wherein the electrical monitoring apparatus is configured to monitor the impedance between the capture device electrode and the ligation element electrode by monitoring the impedance at a selected amplitude between the capture device electrode and the ligation element electrode 
     
     
         76 . A system according to  claim 68 , wherein the electrical monitoring apparatus is further configured to compare the monitored impedance to a threshold value to determine whether the capture device has captured atrial tissue. 
     
     
         77 . A system according to  claim 76 , wherein the threshold value comprises a preselected impedance. 
     
     
         78 . A system according to  claim 68 , further comprising actuation apparatus operably coupled to the capture device to actuate the capture device to capture the body tissue, wherein the electrical monitoring apparatus is operably coupled to the actuation apparatus and is further configured to actuate the capture device to capture the body tissue using the actuation apparatus based on the monitored impedance. 
     
     
         79 . A system according to  claim 68 , further comprising actuation apparatus operably coupled to the ligation element to tighten and loosen the ligation element around the body tissue, wherein the electrical monitoring apparatus is operably coupled to the actuation apparatus and is further configured to tighten the ligation element around the body tissue using the actuation apparatus based on the monitored impedance. 
     
     
         80 . A tissue capture system comprising:
 a capture device configured to capture body tissue;   a capture shaft comprising an elongated body comprising a proximal end and a distal end, wherein the distal end of the capture shaft is coupled to the capture device;   pressure-sensing apparatus operably coupled to the capture device; and   electrical monitoring apparatus operably coupled to the pressure-sensing apparatus, wherein the electrical monitoring apparatus is configured to measure the amount of pressure applied by the capture device.   
     
     
         81 . A system according to  claim 80 , wherein the capture device comprises a first jaw and a second jaw, wherein the first jaw and the second jaw comprise an open configuration in which the first jaw and the second jaw are open and a closed configuration in which the first jaw and the second jaw are closed, wherein an interior surface of the first jaw is located closer to an interior surface of the second jaw when the first jaw and the second jaw are in the closed configuration than when the first jaw and the second jaw are in the open configuration, wherein the pressure-sensing apparatus is operably coupled to the first jaw and the second jaw of the capture device to monitor the amount of pressure applied by the capture device. 
     
     
         82 . A system according to  claim 80 , wherein the electrical monitoring apparatus is further configured to:
 compare the monitored pressure applied by the capture device to a threshold value; and   determine whether the body tissue is captured by the capture device based on the comparison between the monitored pressure and the threshold value.   
     
     
         83 . A system according to  claim 80 , wherein the electrical monitoring apparatus is further configured to report to a user the amount of pressure applied by the capture device. 
     
     
         84 . A system according to  claim 80 , wherein the electrical monitoring apparatus is further configured to record the pressure applied by the capture device. 
     
     
         85 . A system according to  claim 80 , further comprising force-limiting apparatus operably coupled to the electrical monitoring apparatus and to the capture device to restrict the amount of pressure applied by the capture device to the body tissue, wherein the electrical monitoring apparatus is further configured to limit the amount of pressure applied by the capture device based on the comparison between the monitored pressure and the threshold value. 
     
     
         86 . A system according to  claim 80 , further comprising actuation apparatus operably coupled to the capture device to actuate the capture device to capture the body tissue, wherein the electrical monitoring apparatus is operably coupled to the actuation apparatus and is further configured to actuate the capture device to capture the body tissue using the actuation apparatus based on the amount of pressure applied by the capture device. 
     
     
         87 . A tissue capture system comprising:
 a capture device;   a capture shaft comprising an elongated body comprising a proximal end and a distal end, wherein the distal end of the capture shaft is coupled to the capture device;   pulse oximetry apparatus coupled to the capture device, wherein the pulse oximetry apparatus comprises:
 a transmitter coupled to the capture device configured to transmit light; and 
 a receiver coupled to the capture device configured to receive light emitted from the transmitter; and 
   electrical monitoring apparatus operably coupled to the pulse oximetry apparatus, wherein the electrical monitoring apparatus is configured to monitor the light received by the receiver.   
     
     
         88 . A system according to  claim 87 , wherein the capture device comprises a first jaw and a second jaw, wherein the first jaw and the second jaw comprise an open configuration in which the first jaw and the second jaw are open and a closed configuration in which the first jaw and the second jaw are closed, wherein an interior surface of the first jaw is located closer to an interior surface of the second jaw when the first jaw and the second jaw are in the closed configuration than when the first jaw and the second jaw are in the open configuration. 
     
     
         89 . A system according to  claim 88 , wherein the transmitter is coupled to the first jaw and the receiver is coupled to the second jaw. 
     
     
         90 . A system according to  claim 87 , wherein the electrical monitoring apparatus is further configured to determine whether the capture device has captured tissue based on the light received by the receiver. 
     
     
         91 . A system according to  claim 87 , wherein the electrical monitoring apparatus is further configured to compare the light received by the receiver to a threshold value to determine whether the capture device has captured the body tissue. 
     
     
         92 . A system according to  claim 87 , further comprising actuation apparatus operably coupled to the capture device to actuate the capture device to capture the body tissue, wherein the electrical monitoring apparatus is operably coupled to the actuation apparatus and is further configured to actuate the capture device to capture the body tissue using the actuation apparatus based on the light received by the receiver. 
     
     
         93 . A system according to  claim 87 , further comprising:
 a ligation element configured to ligate the body tissue; and   actuation apparatus operably coupled to the ligation element to tighten and loosen the ligation element around the body tissue, wherein the electrical monitoring apparatus is operably coupled to the actuation apparatus and is further configured to tighten the ligation element around the body tissue using the actuation apparatus based on the light received by the receiver.