Abstract: Devices and methods are described for facilitating passage of a probe or other element across an anatomical boundary. In some embodiments, the probe may be an intracardiac echo (ICE) probe, and the anatomical boundary may be the interatrial septum (IAS). The probe is delivered via transcatheter access from a femoral vein to the right atrium using a moveable guide catheter through which the probe and a wire with a resizable distal loop are advanced. The probe and wire may extend through respective lumens of the guide catheter. The loop may be resized to track, capture, and release a sheath, such that a transcatheter delivered medical device such as a left atrial appendage (LAA) occlusion device or other device, may traverse the IAS with the ICE probe via a single puncture site.

Abstract: Surgical devices and methods for excluding the left atrial appendage (LAA) via a thoracoscopic approach or at the time of open heart surgery. The device includes a trocar for accessing the LAA and a delivery system for implantation of the occlusion implant through the trocar. The occlusion implant can be an expandable metal clip or an expandable metal-framed occlusion device that includes a tissue scaffold. The trocar is placed through an opening in the tip of the LAA, then the occlusion implant is delivered through it and placed near the ostium of the LAA to seal it off from the left atrium. The hole in the tip of the LAA is then closed. Other associated surgical devices and methods are described.

Abstract: Devices and methods for occluding the left atrial appendage (LAA) with a device having multifunctional capability. The device is delivered via transcatheter delivery into the LAA and anchored using a compliant frame and scaffold, which may be foam. The device further includes one or more electronic systems to provide a multitude of features related to sensing, electrical stimulation, pacing, communication, etc. The device may have an open configuration where an opening in the proximal end of the device allows for delivery of one or more sensors into and/or through the device. The device may be manipulated into a closed configuration to secure the electronic systems therein and close off the proximal end to provide the occlusive effects. The electronic systems therein may then be used for the various electronic and other functions.