Novel Suturing Device Facilitates Soft Tissue Closure

The Lariat suture delivery device is intended for use in surgical applications where soft tissues need to be approximated and ligated. It is based on a pre-tied, common polyester suture loop to provide complete closure with no metal, clip, or implant left behind. The user-controlled remote delivery system can deliver the 40-mm suture loop through an access of 4.3 mm or greater, and is compatible with a wide range of anatomical shapes. One of the primary indications is for ligating the left atrial appendage (LAA) to treat atrial fibrillation (AF).

The collapsible snare retains the suture loop until ready to deploy, opening or closing it as needed to confirm placement prior to suture release. Once in position, the Meltzer knot is tightened with the Tensure integrated suture-tightening system, reducing the risk of operator variability during closure. The low profile design also gives surgeons greater control in suture placement, and is designed to be compatible with open- chest, thoracotomy, or port access procedures. The Lariat suture delivery device is a product of SentreHEART (Redwood City, CA, USA), and has received the European community CE marking of approval.

“The Lariat surgical device solves many of the issues posed by current closure technologies in surgery,” said Russell Seiber, president and CEO of SentreHEART. “Improving the surgeon's control, reducing operator variability, and minimizing technique dependence through a simple to deliver, repeatable, suture-based solution is more natural for cardiac surgeons and should lead to better outcomes.”

“The Lariat surgical device is an elegant surgical closure solution, combining the best of all the current approaches into a single device,” said associate professor of cardiac surgery Krzysztof Bartus MD, PhD, of Jagiellonian University (Krakow, Poland). “The new device enables flexibility in my approach and access to close tissue where I want, with the additional confidence that it will remain closed. These are important characteristics when closing soft tissue such as the LLA.”

The LAA is a small, ear-shaped sac in the muscle wall of the left atrium. In normal hearts, the heart contracts with each heartbeat, and the blood in the left atrium and LAA is squeezed out into the left ventricle. When a patient has AF, the chaotic impulses do not give the atria time to contract, and blood collects and can form clots in the LAA and atria. The LAA is thought to be the source of more than 90% of stroke-causing blood clots that come from the heart in non-valvular AF patients.

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