Devices and methods for left atrial appendage closure

Abstract

Described here are closure devices and methods for ligating tissue, such as the left atrial appendage. Generally, the closure devices include an elongate body, a snare loop assembly comprising a snare and a suture loop, and a shuttle connected to the snare and releasably coupled to the elongate body and retractable therein. In some variations, the shuttle may be configured to fit into the lumen. In other variations, a handle may be attached to the elongate body, and the handle may comprise a track and a snare control coupled to the track. The handle may be configured to release the shuttle from the elongate body and allow movement of the snare control along the track to retract the snare loop and the shuttle into a lumen of the elongate body.

We claim: 
     
         1 . A device for closing a target tissue comprising:
 an elongate body comprising a lumen therethrough, wherein the elongate body comprises a tip at a distal end, wherein the tip comprises a first lumen and a side opening, wherein the first lumen extends through the elongate body, wherein the side opening extends along a side wall of the elongate body;   a snare loop assembly comprising a snare and a suture loop releasably coupled to the snare, the snare loop assembly extending from the tip, wherein the snare comprises a moveable proximal end and a distal end releasably coupled to the elongate body, wherein the moveable proximal end of the snare extends from the first lumen, wherein the distal end of the snare extends from the side opening; and   a handle configured to retract the distal end of the snare into a lumen of the elongate body after the distal end is released.   
     
     
         2 . The device of  claim 1 , wherein the tip comprises a second lumen, wherein the second lumen extends through the elongate body. 
     
     
         3 . The device of  claim 2 , wherein the suture loop comprises a suture knot, wherein the suture knot extends through the second lumen. 
     
     
         4 . The device of  claim 1 , further comprising a shuttle at the tip and coupled to the distal end of the snare, wherein the shuttle releasably couples the distal end of the snare to the elongate body. 
     
     
         5 . The device of  claim 4 , wherein the distal end of the snare is positioned in the side opening when the shuttle is coupled to the elongate body. 
     
     
         6 . The device of  claim 4 , wherein the shuttle fixedly couples the distal end of the snare to the elongate body in a deployed configuration. 
     
     
         7 . The device of  claim 6 , wherein the shuttle is coupled to a side wall of the elongate body in the deployed configuration. 
     
     
         8 . The device of  claim 4 , wherein the shuttle has a maximum dimension that is less than a diameter of the lumen. 
     
     
         9 . The device of  claim 1 , wherein the side opening is an L-shaped recess in a side wall of the elongate body. 
     
     
         10 . The device of  claim 1 , wherein a distal portion of the snare is positioned in the side opening when the distal end of the snare is coupled to the elongate body. 
     
     
         11 . The device of  claim 1 , wherein the handle comprises a track, a snare control coupled to the track, and a lock configured to limit movement of the snare control along the track, wherein the lock is releasably coupled to the track. 
     
     
         12 . The device of  claim 11 , wherein the handle further comprises a release assembly configured to release the distal end of the snare from the elongate body and allow movement of the snare control along the track. 
     
     
         13 . The device of  claim 12 , wherein the track comprises a first portion and a second portion, and the lock limits movement of the snare control along the second portion of the track. 
     
     
         14 . The device of  claim 1 , wherein a proximal portion of the tip comprises a tip chamfer. 
     
     
         15 . The device of  claim 14 , wherein the tip chamfer is 30 degrees and offset from the tip lumen.