Medtronic Achieves World’s First Minimally Invasive Implantation of Penditure™ Left Atrial Appendage Clip During Mitral Valve Repair

Medtronic's Penditure System for Patients Undergoing Left Atrial Appendage Occlusion

Recently, the Harrington Heart & Vascular Institute (University Hospitals (UH) Harrington Heart & Vascular Institute) became the world's first center to implant the Medtronic Penditure Left Atrial Appendage (LAA) Clip System using a minimally invasive approach during mitral valve repair surgery. This marked the first time this device and method were simultaneously used in a patient.

The Left Atrial Appendage (LAA) is a small pouch that extends from the left atrium of the heart. Everyone has an LAA, but its size and anatomical structure vary. A person’s LAA can potentially cause issues such as atrial fibrillation and stroke. On November 27, 2023, Medtronic launched the Penditure LAA System in the United States. It is an implantable clip preloaded on a single-use delivery system designed to address problems associated with the left atrial appendage. The clip is curved to better match the atrial anatomy and is designed without fabric to improve closure and reduce inflammation. The Penditure device is the only left atrial appendage clip that can be recaptured, repositioned, and redeployed after the initial deployment during surgery, giving surgeons greater control.

The Penditure system was designed to be placed simultaneously with heart surgery, but just one day after its launch in the United States, Dr. Gregory Rushing and Dr. Yasir Abu-Omar, cardiac surgeons at the UH Harrington Heart & Vascular Institute, successfully completed a case using a minimally invasive approach during mitral valve repair.

"Heart Failure and Transplant Center Advanced Surgical Director Dr. Abu-Omar, along with Russ and Connie Lincoln, Chair of Cardiovascular Innovation at the UH Harrington Heart & Vascular Institute, stated: 'Every day, our team at the UH Harrington Heart & Vascular Institute works to find new treatments and methods to reduce cardiovascular morbidity and mortality and improve patients' lives. Implanting the Penditure system in minimally invasive mitral valve repair addresses two issues for patients in a single, less invasive procedure. Compared to surgery, they experience less pain and recover more easily.'"

Dr. Rushing, Director of the Surgical Atrial Fibrillation Program at the UH Harrington Heart & Vascular Institute, stated: "We have extensive expertise in providing isolated minimally invasive left atrial appendage occlusion through left-sided video-assisted surgery, a technique that is not widely used. Due to its minimally invasive nature, easier recovery, and the ability to immediately discontinue anticoagulant medications, it offers significant benefits to our patients."

Although UH was the first center in the world to implant the Penditure system using a minimally invasive approach, it was the fourth center globally and the first in Ohio to implant the system traditionally alongside heart surgery. David Gibson, 75, from Walbridge, Ohio, traveled 100 miles to receive care at the UH Harrington Heart & Vascular Institute. He was diagnosed with extensive coronary artery disease, leading to ischemic cardiomyopathy and heart failure. His heart was weak and did not pump blood well due to blocked coronary arteries, triggering symptoms such as excessive coughing and shortness of breath. Gibson received the Penditure clip during heart surgery on the first day the system became available in the U.S. "Dr. Racine called me the night before my surgery. I didn’t have much pain or discomfort after the procedure, and now I feel much better. My coughing and shortness of breath are gone. It was a very good experience," said Gibson.

Penditure is the only left atrial appendage (LAA) closure device that can be recaptured, repositioned, and redeployed after deployment during surgery. It is an innovative implantable clip that uses physical compression to occlude the LAA, designed to assist in the management of the left atrial appendage in cardiac surgical procedures (LAAM). Penditure consists of a closure clip and a single-use delivery system, with the closure clip preloaded into the delivery system. Based on the size of the closure clip, Penditure is available in four specifications (similar to AtriCure products), capable of occluding LAA effective lengths of 35mm, 40mm, 45mm, and 50mm. The closure clip has an arc-shaped design for better anatomical alignment with the atrium, and it does not include fabric, enabling atraumatic closure and reducing inflammation.

The technical opinions in this article do not represent the views of CCI.

Planning: Shen Li/Editor: Chen Baolin

Author: Yun Ye Xuan /Production: Wang Rui