Retraction of the Left Atrial Appendage

Abstract

A clamp is provided for attachment to the left atrial appendage (LAA). The clamp can be locked in a closed position so as to remain in place on the LAA. After being attached to the LAA, the clamp can be moved to a desired position such that the LAA can be retracted to a desired extent. The clamp can be held in any desired position, preferably by being connected to a thoracic retractor that is being used to retract the patient's sternum or ribs. A movable member is connected between the clamp and a stationary portion of the retractor. By locking the movable member in a fixed position relative to the stationary portion, the clamp can be maintained in a desired position and the LAA can be retracted as desired.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a clamp and retractor according to the invention showing the clamp in an extended position where it is grasping a patient's LAA;

FIG. 2 is a view similar to FIG. 1 showing the clamp and the LAA in retracted positions;

FIG. 3 is a perspective view of the clamp of FIG. 1 showing a rod connected to, and projecting from, the clamp;

FIG. 4 is a perspective view of another embodiment of the invention showing the clamp of FIG. 1 attached to a retractor by a removable, vertically extending rod; and

FIG. 5 is a perspective view of another embodiment of the invention showing the clamp of FIG. 1 connected to a retractor by a removable, adjustable gooseneck.

Claims

1. A device for retracting the left atrial appendage (LAA) of a heart during the course of a cardiovascular surgical procedure, comprising: a clamp, the clamp being movable between a first, closed position where the clamp is connected to the LAA and a second, open position where the clamp is released from the LAA; andmeans for holding the clamp in a desired position relative to the heart while the clamp is in the closed position.

2. The device of claim 1, wherein the clamp is of the Pennington tissue forceps type.

3. The device of claim 2, wherein the clamp includes a pair of movable jaws that engage the LAA between them when the clamp is in the closed position, the LAA-engaging portions of the jaws being knurled or otherwise textured.

4. The device of claim 1, wherein the means for holding the clamp includes: a thoracic retractor, the retractor being engageable with a patient's sternum or ribs to retract the sternum or ribs, the retractor, while retracting the sternum or ribs, having a stationary portion that remains stationary during the surgical procedure; anda movable member, the movable member being connected to the clamp, the movable member also being connected to the stationary portion and movable relative thereto, the movable member capable of being locked in a desired position relative to the stationary portion.

5. The device of claim 4, wherein: the clamp includes a first rod that projects outwardly of the clamp; andthe movable member includes a first universal clamp that is connected to the first rod and to the thoracic retractor.

6. The device of claim 5, further comprising: a second rod that is connected to the thoracic retractor and maintained in a fixed position relative thereto;a second universal clamp; anda third rod, wherein the first universal clamp is connected between the first rod and the third rod, and the second universal clamp is connected between the second rod and the third rod.

7. The device of claim 5, further comprising: a second rod;a second clamp to which the second rod is connected, the second clamp being connected to the thoracic retractor such that the second rod can be moved relative to the thoracic retractor and then locked in a fixed position relative to the thoracic retractor; andthe first universal clamp being connected to the second rod.

8. The device of claim 4, further comprising an adjustable gooseneck connector having first and second ends, the clamp being connected to the first end of the gooseneck connector and the second end of the gooseneck connector being connected to the thoracic retractor.

9. A device for retraction of the left atrial appendage (LAA) of a heart during the course of a cardiovascular surgical procedure, comprising: a thoracic retractor, the retractor being engageable with a patient's sternum or ribs to retract the sternum or ribs, the retractor, while retracting the sternum or ribs, having a stationary portion that remains stationary during the surgical procedure;a movable member, the movable member being connected to the stationary portion and movable relative thereto, the movable member capable of being locked in a desired fixed position relative to the stationary portion; anda clamp, the clamp being connected to the movable member, the clamp being movable between a first, closed position where the clamp is connected to the LAA and a second, open position where the clamp is released from the LAA, the connection between the movable member and the stationary member and the connection between the clamp and the movable member being such that the LAA can be stretched away from the heart when the clamp is in the closed position.

10. The device of claim 9, wherein the clamp is of the Pennington tissue forceps type.

11. The device of claim 10, wherein the clamp includes a pair of movable jaws that engage the LAA between them when the clamp is in the closed position, the LAA-engaging portions of the jaws being knurled or otherwise textured.

12. The device of claim 9, wherein: the clamp includes a first rod that projects outwardly of the clamp; andthe movable member includes a first universal clamp that is connected to the first rod and to the thoracic retractor.

13. The device of claim 12, further comprising: a second rod that is connected to the thoracic retractor and maintained in a fixed position relative thereto;a second universal clamp; anda third rod, wherein the first universal clamp is connected between the first rod and the third rod, and the second universal clamp is connected between the second rod and the third rod.

14. The device of claim 12, further comprising: a second rod;a second clamp to which the second rod is connected, the second clamp being connected to the thoracic retractor such that the second rod can be moved relative to the thoracic retractor and then locked in a fixed position relative to the thoracic retractor; andthe first universal clamp being connected to the second rod.

15. The device of claim 4, further comprising an adjustable gooseneck connector having first and second ends, the clamp being connected to the first end of the gooseneck connector and the second end of the gooseneck connector being connected to the thoracic retractor.

16. A method of retracting the left atrial appendage (LAA) of a heart during the course of a cardiovascular surgical procedure, comprising the steps of: providing a clamp, the clamp being movable between a first, closed position where the clamp can be connected to the LAA and a second, open position where the clamp can be released from the LAA;attaching the clamp to the LAA by moving the clamp to the closed position;moving the clamp to a selected position where the LAA is stretched to a desired extent; andholding the clamp in the selected position.

17. The method of claim 17, wherein the step of holding the clamp in the selected position is accomplished by: providing a thoracic retractor;engaging a patient's sternum or ribs with the retractor to retract the sternum or ribs, the retractor, while retracting the sternum or ribs, having a stationary portion that remains stationary during the surgical procedure;providing a movable member;connecting the movable member to the clamp;connecting the movable member to the stationary portion such that the movable member and the clamp are movable relative to the stationary portion;moving the movable member and the clamp to the selected position; andmaintaining the movable member and the clamp in the selected position.