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 method of ligating atrial tissue comprising:
 capturing selected atrial tissue using a capture device coupled to a capture shaft at a distal end of the capture shaft after advancing the capture device into a pericardial space;   positioning a loop of a ligation element around the selected atrial issue after capturing the selected atrial tissue, wherein the ligation element is located proximate the distal end of the capture shaft;   tightening the loop to ligate the selected atrial tissue located in the loop;   monitoring an impedance between a capture device electrode and a ligation element electrode, wherein the capture device electrode is coupled to the capture device and the ligation element electrode is coupled to the ligation element, and wherein tightening the loop places a ligation element electrode in contact with the selected atrial tissue located in the loop; and   determining whether the capture device has captured atrial tissue based on the monitored impedance.   
     
     
         69 . A method 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 method 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 method according to  claim 68 , wherein the method further comprises restricting the amount of force applied to the selected atrial tissue by the capture device based on the monitored impedance. 
     
     
         72 . A method according to  claim 68 , wherein the method further comprises restricting the amount of force applied to the selected atrial tissue by the ligation element when tightening the ligation element based on the monitored impedance. 
     
     
         73 . A method according to  claim 68 , the method further comprising providing an indication to a user to restrict the amount of force applied by the capture device based on the monitored impedance. 
     
     
         74 . A method according to  claim 68 , wherein monitoring the impedance between the capture device electrode and the ligation element electrode comprises monitoring the impedance at a selected frequency. 
     
     
         75 . A method according to  claim 68 , wherein monitoring the impedance between the capture device electrode and the ligation element electrode comprises monitoring the impedance at a selected amplitude. 
     
     
         76 . A method according to  claim 68 , wherein determining whether the capture device has captured atrial tissue based on the monitored impedance comprises comparing the monitored impedance to a threshold value. 
     
     
         77 . A method according to  claim 68 , further comprising actuation apparatus operably coupled to the capture device to actuate the capture device to capture the selected atrial tissue, wherein the method comprises actuating the actuation apparatus based on the monitored impedance. 
     
     
         78 . A method of capturing atrial tissue comprising:
 capturing selected atrial tissue using a capture device coupled to a capture shaft at a distal end of the capture shaft after advancing the capture device into a pericardial space; and   measuring the amount of pressure applied to the selected atrial tissue by the capture device.   
     
     
         79 . A method according to  claim 78 , 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 measuring the amount of pressure comprises using pressure-sensing apparatus operably coupled to the first jaw and the second jaw of the capture device to measure the amount of pressure applied by the capture device. 
     
     
         80 . A method according to  claim 78 , the method further comprising:
 comparing the measured pressure to a threshold value; and   confirming that the selected atrial tissue captured by the capture device is atrial tissue based on the comparison between the monitored pressure and the threshold value.   
     
     
         81 . A method of capturing atrial tissue comprising:
 capturing selected atrial tissue using a capture device coupled to a capture shaft at a distal end of the capture shaft after advancing the capture device into a pericardial space;   confirming that the capture device has captured tissue using 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 wherein the confirming comprises monitoring the light received by the receiver.   
     
     
         82 . A method according to  claim 81 , 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. 
     
     
         83 . A method according to  claim 82 , wherein the transmitter is coupled to the first jaw and the receiver is coupled to the second jaw. 
     
     
         84 . A method according to  claim 81 , wherein the method comprises comparing the light received by the receiver to a threshold value to determine whether the capture device has captured tissue. 
     
     
         85 . A method according to  claim 81 , further comprising actuation apparatus operably coupled to the capture device to actuate the capture device to capture tissue, wherein the method further comprises actuating the capture device to capture the body tissue using the actuation apparatus based on the light received by the receiver. 
     
     
         86 . A method according to  claim 81 , the method further comprising:
 positioning a loop of a ligation element around the captured issue after capturing the tissue, wherein the ligation element is located proximate the distal end of the capture shaft; and   tightening the loop to ligate the captured tissue located in the loop.