Patent Description:
Atrial Fibrillation (AF) is the common continuous arrhythmia in clinic. The incidence of AF in the general population is <NUM>-<NUM>%. The main hazard of AF is to promote thrombosis. Complications such as stroke and peripheral vascular embolization caused by thrombus detachment significantly increase the disability and fatality rate. Stroke is the most common and devastating complication of AF. About <NUM> million people worldwide suffer from stroke each year, <NUM>-<NUM>% of which are attributed to AF. The study suggests that <NUM>% of patients with rheumatic heart disease have a cardiogenic thrombus from the left atrial appendage, and more than <NUM>% of thrombi in the patients with non-valvular AF are formed in the left atrial appendage. Therefore, the intervention of the left atrial appendage to prevent thromboembolism in patients with AF, especially stroke, has important theoretical and clinical significance.

Anticoagulant therapy is a standard method for preventing complications of stroke and AF at present, but has certain limitations. Therefore, the use of safer and more effective measures to prevent AF and stroke is of great significance. At present, medical interventions are mostly used to occlude the left atrial appendage. The commonly used left atrial appendage occluders comprise a single plug type occluder represented by WATCHMAN and a plug-and-disc type left atrial appendage occluder represented by AMPLATZER Cardiac Plug (ACP).

The plug type left atrial appendage occluder has a nickel-titanium alloy frame with a self-expanding structure and barbs fixed around. The surface of the occluder towards atrial is covered with a porous polytetrafluoroethylene membrane for blood inflow outflow in the left atrial appendage.

When the plug type left atrial appendage occluder has been plugged into the left atrial appendage, the entrance of left atrial appendage cannot be completely occluded since the shape of the entrance of the left atrial appendage is irregular, and the occluder has a limited deformability. Therefore, it is difficult to eliminate the thrombus caused by leakage of the left atrial appendage due to AF. The left atrial appendage has different structures and depths, and in addition, a multi-cavity structure. The plug type occluder is unable to fully adapt to the anatomical structures of all left atrial appendages as well as to achieve a stable fixation.

The plug-and-disc type left atrial appendage occluder is a two-disc type device consisting of a butterfly blade which would be placed in the left atrial appendage and a butterfly cap. The butterfly blade and the butterfly cap are connected by a concave waist. The butterfly blade is placed in the left atrial appendage to prevent the occluder from shifting. The butterfly cap seals the entrance of the left atrial appendage.

The plug-and-disc type left atrial appendage occluder has a structure in which the sealing disc and the fixed disc are integrated, and cannot be completely deformed independently. After the plug is plugged into the left atrial appendage, the disc portion adhered to the entrance of the left atrial appendage is subjected to the pull of the plug portion, so that the disc portion cannot fully fit to the entrance of the left atrial appendage, and thus it is difficult to achieve an optimal occluding effect. Moreover, since the length adjustments of the plug portion and the disc portion are limited, it is difficult to achieve the optimal fixation and blood flow blockage, and the disc structure does not adapt to different lumen shapes of the left atrial appendage.

<CIT> discloses a left atrial appendage occluder having elastic cover and anchoring substructures. The left atrial appendage occluder has H-shaped cross sections and seals the appendages by pinching an annular region of ostium tissue between the cover and the anchoring substructures.

<CIT> discloses a left atrial appendage occlusion device comprising at least one deployable tissue anchor that is configured to deploy from a constrained configuration to a deployed configuration and retractable from the deployed configuration to a retracted configuration within the body.

<CIT> discloses a medical device includes an occluder portion having an occluder eyelet and an anchor portion having an anchor eyelet, the anchor eyelet hingeably coupled to the occluder eyelet to make the anchor portion capable of moving between a retracted position and a deployed position upon the occluder portion being in an expanded position.

<CIT> also discloses an implantable device for the left atrium of a heart, wherein at least the one portion in the secondary form has a first part facing outwardly away from the other portion and a second part which deploys first from the primary form into the secondary form and which is folded back in a direction towards the other portion on to the first part.

In short, no matter the plug type left atrial appendage occluder or the plug-and-disc type left atrial appendage occluder, once separated from the delivery system, it will be impossible for the left atrial appendage occluder to be again engaged with the delivery system for positional adjustments, if an undesired position of the left atrial appendage occluder or a leakage of occlusion is founded. This would bring a great trouble to the operator's subsequent operations.

It is an object of the present application to provide a left atrial appendage occluder and left atrial appendage occlusion device to solve the problem existed in the prior art that, once separated from the delivery system, it will be impossible for the left atrial appendage occluder to be again engaged with the delivery system for positional adjustments, if an undesired position of the left atrial appendage occluder or an leakage of occlusion is founded.

To solve the above technical problem, the application provides a left atrial appendage occluder according to claim <NUM>.

Optionally, in the left atrial appendage occluder, the distal end of the guiding member is a blunt end.

Optionally, in the left atrial appendage occluder, the guiding member is a guide wire having a ball head or a hook at the distal end thereof.

Optionally, in the left atrial appendage occluder, the occlusion member comprises a frame, a polymer membrane covering the frame and anchors fixed on the frame, and the elastic opening is formed by means of the polymer membrane.

Optionally, in the left atrial appendage occluder, the polymer membrane comprises a plurality of membrane sheets and interstices between the plurality of membrane sheets form the elastic opening, or the polymer membrane comprises a plurality of interlaced membrane wires and interstices between the plurality of interlaced membrane wires form the elastic opening.

The present application also provides a left atrial appendage occlusion device according to claim <NUM>.

Optionally, in the left atrial appendage occlusion device, the guiding member is a guide wire having a blunt end at a distal end thereof.

Optionally, in the left atrial appendage occlusion device, the occlusion member has an elastic opening, and the guiding member passes through the elastic opening and is removable out from the elastic opening. The elastic opening contracts upon removal of the guiding member from the elastic opening.

Optionally, in the left atrial appendage occlusion device, the occlusion member comprises a frame, a polymer membrane covering the frame and anchors fixed on the frame, and the elastic opening is formed by means of the polymer membrane.

Optionally, in the left atrial appendage occlusion device, the polymer membrane comprises a plurality of membrane sheets and interstices between the plurality of membrane sheets form the elastic opening, or the polymer membrane comprises a plurality of interlaced membrane wires and interstices between the plurality of interlaced membrane wires form the elastic opening.

In the left atrial appendage occluder and left atrial appendage occlusion device provided in the present application, after the push member is separated from the occlusion member, the guiding member is able to guide the push member to allow an easy reconnection between the occlusion member and push member for repositioning, when the push member is needed to be connected to the occlusion member again.

The left atrial appendage occluder and left atrial appendage occlusion device provided in present application will be described below in further detail with reference to specific embodiments and accompanying drawings. Features and advantages of the application will be more apparent from the following detailed description and appended claims. It should be noted that the drawings are in a very simplified form and not necessarily presented to scale, for the only purpose to facilitate convenient and explicit description of embodiments of the present application. The structures shown in the accompanying drawings are often parts of the actual structures. In particular, the figures are sometimes drawn using different scales in order to give emphasis on different details.

As used herein, "proximal end" or "distal end" refers to the relative orientation, relative position, or direction of elements or actions that are relative to each other from the perspective of an operator operating the device. Yet without wishing to be limiting in any sense, the "proximal end" generally refers to the end of the medical device close to the operator during its normal operation, while the "distal end" generally refers to the end that enters into the body of the patient first.

The core idea of this application is to provide a left atrial appendage occluder, a left atrial appendage occlusion device and a left atrial appendage occlusion system. The left atrial appendage occluder includes an occlusion member and a guiding member, and the guiding member is located within the occlusion member and is removable out from the occlusion member. The proximal end of the guiding member protrudes out of the proximal end of the occlusion member. The left atrial appendage occlusion device includes the occlusion member, the guiding member and the push member. A distal end of the push member is detachably connected to the proximal end of the occlusion member. The guiding member is located within the occlusion member and push member and is removable from the occlusion member and push member. The proximal end of the guiding member protrudes out of the proximal end of the push member. The left atrial appendage occlusion system includes a delivery catheter and a left atrial appendage occlusion device. The delivery catheter is configured to establish a delivery channel, and the push member is configured to push the occlusion member along the delivery channel. The guiding member is configured, after the push member has been detached from the occlusion member, to guide the push member when the push member is needed to be connected to the occlusion member again. In present application, after the push member has been detached from the occlusion member, the guiding member is able to guide the push member to allow an easy reconnection between the occlusion member and push member for repositioning, when the push member is needed to be connected to the occlusion member again.

Reference is now made to <FIG>. <FIG> schematically illustrates a status of the left atrial appendage occlusion device according to embodiment <NUM> of the present application. <FIG> schematically illustrates another status of the left atrial appendage occlusion device according to embodiment <NUM> of the present application. <FIG> is a structural schematic diagram of the left atrial appendage occluder according to embodiment <NUM> of the present application. As shown in <FIG>, the left atrial appendage occluder <NUM> includes an occlusion member <NUM> and a guiding member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and is removable from the occlusion member <NUM> while the proximal end of the guiding member <NUM> protrudes out of the proximal end of the occlusion member <NUM>. Due to the guiding member <NUM>, the above left atrial appendage occluder <NUM> becomes a left atrial appendage occluder having a guiding function. After release of the left atrial appendage occluder <NUM> (more specifically, the occlusion member <NUM>) by the push member, if the left atrial appendage occluder <NUM> is found to be released to an undesired position, or a leakage of occlusion or other situations are occurred, the push member can be easily engaged with the left atrial appendage occluder <NUM> (more specifically, the occlusion member <NUM>) again under the guide of the guiding member <NUM>, so that repositioning, withdrawal or another operations of the left atrial appendage occluder <NUM> are able to be achieved.

With continued reference to <FIG>, in this embodiment, the left atrial appendage occlusion device <NUM> includes an occlusion member <NUM>, a guiding member <NUM> and a push member <NUM>. A distal end of the push member <NUM> is detachably connected to the proximal end of the occlusion member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and push member <NUM> and is removable from the occlusion member <NUM> and push member <NUM>. The proximal end of the guiding member <NUM> protrudes out of the proximal end of the push member <NUM>.

Specifically, the connection between the distal end of the push member <NUM> and the proximal end of the occlusion member <NUM> may be accomplished by one of the thread connection, a snap-fit connection, spline connection and plug-pin connection. For example, the distal end of the push member <NUM> is provided with an external thread and the proximal end of the occlusion member <NUM> is provided with an internal thread. Through fit of the external thread and the internal thread, the push member <NUM> is able to be detachably connected to the occlusion member <NUM>. As another example, the distal end of the push member <NUM> is provided with an external spline and the proximal end of the occlusion member <NUM> is provided with an internal spline. Through fit of the external spline and the internal spline, the push member <NUM> is able to be detachably connected to the occlusion member <NUM>.

In this embodiment, the guiding member <NUM> is a guide wire, which may be made of metal. A distal end of the guiding member <NUM> may be located either inside or protrude out of the occlusion member <NUM>. Preferably, the distal end of the guiding member <NUM> protrudes out of the distal end of the occlusion member <NUM>. In this case, the guiding member <NUM> can facilitate positioning of the occlusion member <NUM> during release of the occlusion member <NUM>, so that the occlusion member <NUM> can be easily deployed at a suitable position.

Further, the distal end of the guiding member <NUM> is blunt (i.e., not sharp). In this way, when helping in positioning of the occlusion member <NUM> during its release, the guiding member <NUM> will not cause damages to the surrounding tissues, such as the left atrial appendage, thereby ensuring reliability of the left atrial appendage occluder <NUM> and left atrial appendage occlusion device <NUM>.

In particular, reference is now made to <FIG>, structural schematic diagram of the guiding member according to embodiment <NUM> of the present application, and to <FIG>, another structural schematic diagram of the guiding member according to embodiment <NUM> of the present application. As shown in <FIG>, the distal end of the guiding member <NUM> may be a ball head or a body having an irregular cambered surface. In this way, the distal end of the guiding member <NUM> presents a cambered surface, which will not cause damages to the surrounding tissues. Besides, as shown in <FIG>, the distal end of the guiding member <NUM> may also be a hook, so that no damages would be caused to the surrounding tissues. In another embodiment, the distal end of the guiding member <NUM> may be flexible.

With continued reference to <FIG>, in this embodiment, the occlusion member <NUM> has an elastic opening <NUM>, through which the guiding member <NUM> is passed. In addition, the guiding member <NUM> is removable from the elastic opening <NUM>, and the elastic opening <NUM> contracts upon removal of the guiding member <NUM> from the elastic opening <NUM>. Preferably, the elastic opening <NUM> will be closed after removal of the guiding member <NUM> from the elastic opening <NUM>.

Specifically, the occlusion member <NUM> includes a frame <NUM>, a polymer membrane <NUM> covering the frame <NUM> and anchors <NUM> fixed onto the frame <NUM>. The elastic opening <NUM> is formed by means of the polymer membrane <NUM>. The polymer membrane <NUM> may cover either an exterior or interior surface of the frame <NUM>. The anchors <NUM> may be hook-shaped and made of metal or degradable polymeric material. The anchors <NUM> are fixed to the exterior surface of the frame <NUM>.

The frame <NUM> may be umbrella-shaped and made of metal or degradable polymeric material. Specifically, the frame <NUM> may include a fixing part (not shown) and a plurality of frame strips connected to the fixing part. The plurality of frame strips are uniformly distributed on the fixing part. There are many interstices in frame <NUM> for passing the guiding member <NUM> therethrough. Further, the fixing part may be a hollow tube. Further, the opening of the hollow tube is covered by the polymer membrane <NUM> and the elastic opening is formed here by the polymer membrane <NUM>, which can not only facilitate the passage of the guiding member <NUM> but also ensure a good occlusion effect. In this embodiment, the fixing part is located at the proximal end of the frame <NUM> (or, the occlusion member <NUM>). Preferably, the fixing part is provided with a connecting structure, such as the thread or spline structure, to facilitate the detachable connection with the push member <NUM>.

Reference is now made to <FIG>, a structural schematic diagram of the elastic opening according to embodiment <NUM> of the present application, and to <FIG>, another structural schematic diagram of the elastic opening according to embodiment <NUM> of the present application. As shown in <FIG>, the elastic opening <NUM> may be formed as follows: the polymer membrane <NUM> includes a plurality of membrane sheets <NUM>, and interstices between the plurality of membrane sheets form the elastic opening <NUM>. When the guiding member <NUM> is locating in the elastic opening shown in <FIG>, the membrane sheets <NUM> are squeezed and interstices between the plurality of membrane sheets <NUM> are enlarged, thereby leading to a large elastic opening <NUM>. Upon removal of the guiding member <NUM>, the membrane sheets <NUM> recover, and interstices between the plurality of membrane sheets <NUM> contracts or closes, leading to a small elastic opening <NUM>. Therefore, this design not only facilitates the passage of the guiding member <NUM> but also ensures a good occlusion effect.

Further, as shown in <FIG>, the elastic opening <NUM> may also be implemented as follows : the polymer membrane <NUM> comprises a plurality of interlaced membrane wires <NUM>, and interstices between the plurality of interlaced membrane wires <NUM> forms the elastic opening <NUM>. When the guiding member <NUM> is locating in the elastic opening <NUM> shown in <FIG>, the membrane wires <NUM> are squeezed and interstices between the plurality of interlaced membrane wires <NUM> are enlarged, leading to a large elastic opening <NUM>. Upon removal of the guiding member <NUM>, the membrane wires <NUM> recover, and interstices between the plurality of interlaced membrane wires <NUM> contracts or closes, leading to a small elastic opening <NUM>. Therefore, this design not only facilitates the passage of the guiding member <NUM> but also ensures a good occlusion effect.

Accordingly, this embodiment also provides a left atrial appendage occlusion system. Referring to <FIG>, the left atrial appendage occlusion system includes a delivery catheter <NUM> and the left atrial appendage occlusion device <NUM>. The delivery catheter <NUM> is configured to establish a delivery channel, and the push member <NUM> is configured to push the occlusion member <NUM> along the delivery channel. The guiding member <NUM> is configured, after the push member <NUM> has been detached from the occlusion member <NUM>, to guide the push member <NUM> when the push member <NUM> is needed to be connected to the occlusion member <NUM> again.

With continued reference to <FIG>, occlusion of the left atrial appendage by the occlusion member <NUM> is achievable as follows: the delivery catheter <NUM> establishes a delivery channel and the guiding member <NUM> helps in positioning the release position of the occlusion member <NUM>. The occlusion member <NUM> is pushed out of terminal of the delivery catheter <NUM> by the push member <NUM> and is released. At this time, the occlusion member <NUM> is plugged and tightly fitted into the left atrial appendage wall. After that, the push member <NUM> is detached from the occlusion member <NUM>. Further, the push member <NUM> can be removable from the delivery catheter <NUM>, meanwhile the push member <NUM> can also be separated from the guiding member <NUM>. If an unsatisfactory position of the occlusion member <NUM> or a leakage of the occlusion is found after the separation of the push member <NUM> from the occlusion member <NUM>, the push member <NUM> can be sleeved outside the guiding member <NUM> again and is reconnected to the occlusion member <NUM> along the guiding member <NUM>, so that the occlusion member <NUM> is able to be repositioned or withdrawn. Therefore, after the push member <NUM> has been separated from the occlusion member <NUM>, the guiding member <NUM> is able to guide the push member <NUM> when the push member <NUM> is needed to be connected to the occlusion member <NUM> again, so as to allow an easy reconnection of the push member <NUM> and the occlusion member <NUM> for repositioning.

Reference is now made to <FIG>. <FIG> is structural schematic diagram of the left atrial appendage occlusion device according to embodiment <NUM> of the present application. <FIG> is another structural schematic diagram of the left atrial appendage occlusion device according to embodiment <NUM> of the present application. <FIG> is yet another structural schematic diagram of the left atrial appendage occlusion device according to embodiment <NUM> of the present application. As shown in <FIG>, in this embodiment, the left atrial appendage occluder <NUM> includes an occlusion member <NUM> and a guiding member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and is removable from the occlusion member <NUM>, while the proximal end of the guiding member <NUM> protrudes out of the proximal end of the occlusion member <NUM>. The left atrial appendage occlusion device <NUM> includes the occlusion member <NUM>, the guiding member <NUM> and the push member <NUM>. A distal end of the push member <NUM> is detachably connected to the proximal end of the occlusion member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and push member <NUM> and is removable from the occlusion member <NUM> and push member <NUM>. The proximal end of the guiding member <NUM> protrudes out of the proximal end of the push member <NUM>. The left atrial appendage occlusion system includes a delivery catheter and the left atrial appendage occlusion device <NUM>. The delivery catheter is configured to establish a delivery channel, and the push member <NUM> is configured to push the occlusion member <NUM> along the delivery channel. The guiding member <NUM> is configured, after the push member <NUM> has been detached from the occlusion member <NUM>, to guide the push member <NUM> when the push member <NUM> is needed to be connected to the occlusion member <NUM> again.

This embodiment differs from embodiment <NUM> in that, the frame of the occlusion member in embodiment <NUM> has an umbrella shape (the distal end is open) and the occlusion member thus has an umbrella shape, while the frame of the occlusion member in this embodiment has a cage shape (the distal end is closed) frame and the occlusion member thus has a cage shape.

Specifically, the occlusion member <NUM> includes a frame <NUM>, a polymer membrane <NUM> covering the frame <NUM> and anchors <NUM> fixed onto the frame <NUM>. An elastic opening is formed in the polymer membrane <NUM>.

In this embodiment, the frame <NUM> specifically includes a first fixing part (not shown), a second fixing part (not shown) and a plurality of frame strips connected to the first fixing part and the second fixing part. Here, the first fixing part is located at the proximal end of the frame <NUM> and the second fixing part is located at the distal end of the frame <NUM>. There are many interstices in frame <NUM> for passing the guiding member <NUM> therethrough. Specifically, each of the first fixing part and the second fixing part is a hollow tube. Further, the opening of the fixing part may be covered by the polymer membrane <NUM> and the elastic opening is formed here by the polymer membrane <NUM>, which can not only facilitate the passage of the guiding member <NUM> but also ensure a good occlusion effect. In this embodiment, the first fixing part is preferably provided with a connecting structure, such as the thread or spline structure, to facilitate the detachable connection with the push member <NUM>.

As to the guiding member <NUM>, elastic opening, delivery catheter and other components and the relationships between components in embodiment <NUM>, reference can be made to embodiment <NUM> as appropriate, description of which is omitted hereto.

Reference is now made to <FIG>, structural schematic diagram of the left atrial appendage occlusion system according to embodiment <NUM> of the present application. As shown in <FIG>, in this embodiment, the left atrial appendage occluder <NUM> includes an occlusion member <NUM> and a guiding member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and is removable from the occlusion member <NUM>, while the proximal end of the guiding member <NUM> protrudes out of the proximal end of the occlusion member <NUM>. The left atrial appendage occlusion device <NUM> includes the occlusion member <NUM>, the guiding member <NUM> and a push member <NUM>. A distal end of the push member <NUM> is detachably connected to the proximal end of the occlusion member <NUM>. The guiding member <NUM> is located within the occlusion member <NUM> and push member <NUM> and is removable from the occlusion member <NUM> and push member <NUM>. The proximal end of the guiding member <NUM> protrudes out of the proximal end of the push member <NUM>. The left atrial appendage occlusion system includes a delivery catheter <NUM> and the left atrial appendage occlusion device <NUM>. The delivery catheter is configured to establish a delivery channel, and the push member <NUM> is configured to push the occlusion member <NUM> along the delivery channel. The guiding member <NUM> is configured to, after the push member <NUM> has been detached from the occlusion member <NUM>, guide the push member <NUM> when the push member <NUM> is needed to be connected to the occlusion member <NUM> again.

This embodiment differs from Embodiment <NUM> in that, the occlusion member of Embodiment <NUM> comprises one frame, on which each of the polymer membrane and anchors is disposed, and is able to achieve the occlusion of the left atrial appendage as well as the fixation to the left atrial appendage, while the occlusion member in this embodiment includes two frames: a first frame and a second frame.

Specifically, the occlusion member <NUM> includes a frame <NUM>, a polymer membrane covering the frame <NUM> and anchors <NUM> fixed onto the frame <NUM>. An elastic opening is formed in the polymer membrane.

Further, the frame <NUM> includes a first frame <NUM> and a second frame <NUM>. The first frame <NUM> and a second frame <NUM> are connected by the connector <NUM>. The first frame <NUM> is located at the proximal end of the connector <NUM>, while the second frame <NUM> is located at the distal end of the connector <NUM>. The polymer membrane covers the first frame <NUM>, and the anchors <NUM> are fixed on the second frame <NUM>. The first frame <NUM> and the connector <NUM> may be integrally formed, or may be connected by a thread structure or the like. Similarly, the second frame <NUM> and the connector <NUM> may be integrally formed, or may be connected by a thread structure or the like. That is, in this embodiment, occlusion of left atrial appendage can be effected by the first frame <NUM> and the polymer membrane covering the first frame <NUM>, and the fixation of the occlusion member <NUM> on the left atrial appendage can be effected by the second frame <NUM> and the anchors <NUM> fixed on the frame <NUM>. Preferably, the polymer membrane may also cover the second frame <NUM>, which makes the occlusion of left atrial appendage can also be effected by the second frame <NUM> and the polymer membrane covering the second frame <NUM>, thereby achieving a better left atrial appendage occlusion effect.

In this embodiment, each of the first frame <NUM> and the second frame <NUM> has a cage shape, but in other embodiments, each of them may have an umbrella shape; or the first frame <NUM> may have a cage shape while the second frame <NUM> may have an umbrella shape; or the like.

In this embodiment, the first frame <NUM> specifically includes a first fixing part (not shown), a second fixing part (not shown) and a plurality of frame strips connected to the first fixing part and the second fixing part. Here, the first fixing part is located at the proximal end of the first frame <NUM> and the second fixing part is located at the distal end of the first frame <NUM>. There are many interstices in first frame <NUM> for passing the guiding member <NUM> therethrough. Specifically, each of the first fixing part and the second fixing part is a hollow tube. Further, the opening of the first fixing part may be covered by the polymer membrane and the elastic opening is formed here by the polymer membrane, which can not only facilitate the passage of the guiding member <NUM> but also ensure a good occlusion effect. In this embodiment, the first fixing part is preferably provided with a connecting structure, such as the thread or spline structure, to facilitate the connection with the push member <NUM>. Further, the second fixing part may also be provided with a connecting structure, such as the thread or spline structure, to facilitate the connection with the connector <NUM>.

In this embodiment, the second frame <NUM> specifically includes a third fixing part (not shown), a fourth fixing part (not shown) and a plurality of frame strips connected to the third fixing part and the fourth fixing part. Here, the third fixing part is located at the proximal end of the second frame <NUM> and the fourth fixing part is located at the distal end of the second frame <NUM>. There are many interstices in second frame <NUM> for passing the guiding member <NUM> therethrough. Specifically, each of the third fixing part and the fourth fixing part may be a hollow tube. Further, the third fixing part may be provided with a connecting structure, such as the thread or spline structure, to facilitate the connection with the connector <NUM>.

In summary, in the left atrial appendage occluder, left atrial appendage occlusion device and left atrial appendage occlusion system provided in present application, after the push member is separated from the occlusion member, the guiding member is able to guide the push member to allow an easy reconnection between the occlusion member and push member for repositioning when the push member is needed to be connected to the occlusion member again.

Claim 1:
A left atrial appendage occluder (<NUM>, <NUM>, <NUM>), comprising an occlusion member (<NUM>, <NUM>, <NUM>) and a guiding member (<NUM>, <NUM>, <NUM>), wherein the guiding member (<NUM>, <NUM>, <NUM>) is configured to position a push member (<NUM>, <NUM>, <NUM>) to the occlusion member (<NUM>, <NUM>, <NUM>), wherein the guiding member (<NUM>, <NUM>, <NUM>) is located within the occlusion member (<NUM>, <NUM>, <NUM>) and removable from the occlusion member (<NUM>, <NUM>, <NUM>), and wherein a proximal end of the guiding member (<NUM>, <NUM>, <NUM>) protrudes out of a proximal end of the occlusion member (<NUM>, <NUM>, <NUM>), wherein a distal end of the guiding member (<NUM>, <NUM>, <NUM>) protrudes out of a distal end of the occlusion member (<NUM>, <NUM>, <NUM>), characterized in that, the occlusion member (<NUM>, <NUM>, <NUM>) has an elastic opening (<NUM>), through which the guiding member (<NUM>, <NUM>, <NUM>) is passed, and wherein the elastic opening (<NUM>) contracts upon a removal of the guiding member (<NUM>, <NUM>, <NUM>) from the elastic opening (<NUM>).