SYSTEM AND METHOD TO TRACK MOVEMENT OF A TOOL IN PERCUTANEOUS REPLACEMENT OF A HEART VALVE

• US 20080234576A1
• Filed: 03/23/2007
• Published: 09/25/2008
• Est. Priority Date: 03/23/2007
• Status: Abandoned Application

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Soubelet, Elisabeth, Gavit-Houdant, Laurence, Vaillant, Regis
• Application Number:
  US11/690,500
• Publication Number:
  US 20080234576A1
• Time in Patent Office: Days
• US Class Current: 600/434
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A system and method to track movement of a tool in percutaneous replacement of a heart valve of a subject is provided. The system includes an imaging system, a navigation system operable to track movement of the tool through the patient and to illustrate a representation of a position the tool in spatial relation relative to images acquired by the imaging system, and a controller. The controller is operable to identify one of a series of pathways to move the tool through a patient in percutaneous replacement of the heart valve, to identify a sequence of models illustrative of the one of the plurality of pathways, to detect the position of the tool within a threshold of one of the models in the sequence, and to generate display including a representation of the tool superimposed relative to the model within the threshold.

Claims

1. A method to track movement of a tool in percutaneous replacement of a valve of a heart of a subject, the method comprising the steps of:

identifying one of plurality of pathways to move the tool through a patient in percutaneous replacement of the heart valve;

identifying a sequence of models correlated to and illustrative of the one of the plurality of pathways;

tracking the movement of the tool through the patient;

detecting the position of the tool within a threshold of one of the models in the sequence; and

generating a display including a representation of the tool superimposed in spatial relation to the model within the threshold.

2. The method of claim 1, wherein one of the plurality of pathways is a retrograde approach, and wherein the sequence of images correlated to the retrograde approach includes a first model illustrative of arterial iliac bifurcations of the subject, a second model illustrative of the aortic arch, a third model illustrative of the heart valve to be replaced, and a fourth model illustrative of the corresponding ventricle of the heart valve to be replaced, and wherein all of the models are three-dimensional.

3. The method of claim 1, wherein one of the plurality of pathways is an antegrade approach, and wherein the sequence of images correlated to the antegrade approach includes a first model illustrative of the right atria of the heart, a second model illustrative of the left atria of the heart, a third model illustrative of the heart valve to be replaced, and a fourth model illustrative of the ventricle of the valve to be replaced.

4. The method of claim 1, wherein the generating a display step further includes:

detecting the position of the tool within a threshold of a first model in the sequence;

illustrating the representation of the tool in spatial relation relative to the first model;

detecting the position of the tool within a threshold of a second model in the sequence; and

automatically removing the first model from the display and automatically illustrating the representation of the tool in spatial relation relative to the second model.

5. The method of claim 4, the generating the display step further comprising the steps of:

detecting the position of the tool within a threshold of a third model in the sequence; and

automatically removing the second model from the display and automatically illustrating the representation of the tool in spatial relation relative to the third model.

6. The method of claim 1, wherein each of the models in the sequence are spatially arranged on a display relative to one another in accordance to a direction of the selected pathway.

7. The method of claim 1, wherein the sequence comprises a first model illustrative of a left atrium of the heart, a second model illustrative of the coronary sinus, and a third model illustrative of a circumflex coronary artery, and a fourth model illustrative of the mitral valve to be replaced.

8. The method of claim 1, wherein the sequence comprises a first model illustrative of the left or right illiac bifurcation, a second model illustrative of a aorta, a third model illustrative of both an aortic valve and a left ventricle, a fourth model illustrative of a mitral annulus, a mitral valve and a left atrium of the subject.

9. The method of claim 1, wherein the identifying step includes:

measuring a level of blockage along at least one of the plurality of pathways;

comparing a level blockage to a predetermined threshold of blockage; and

selecting another of the plurality of pathways to pass the tool if the level of blockage exceeds the predetermined threshold of blockage.

10. A system operable to track movement of a tool in percutaneous replacement of a heart valve of a subject, comprising:

an imaging system operable to acquire a plurality of images;

a navigation system operable to track movement of the tool through the patient and to illustrate a representation of a position the tool in spatial relation to each of the plurality of images; and

a controller in communication with the imaging system and the navigation system, the controller including a processor in communication to execute a plurality of programmable instructions stored in a memory, the plurality of programmable instructions including;

identifying one of plurality of pathways to move the tool through a patient in percutaneous replacement of the heart valve,

identifying a sequence of models illustrative of the one of the plurality of pathways,

tracking the movement of the tool through the patient,

detecting the position of the tool within a threshold of one of the models in the sequence, and

generating a display including a representation of the tool superimposed relative to the model within the threshold.

11. The system of claim 10, wherein one of the plurality of pathways is a retrograde approach, and wherein the sequence of images correlated to the retrograde approach includes a first model illustrative of arterial iliac bifurcations of the subject, a second model illustrative of the aortic arch, a third model illustrative of the heart valve to be replaced, and a fourth model illustrative of the corresponding ventricle of the heart valve to be replaced, and wherein all of the models are three-dimensional.

12. The system of claim 10, wherein one of the plurality of pathways is an antegrade approach, and wherein the sequence of images correlated to the antegrade approach includes a first model illustrative of the right atria of the heart, a second model illustrative of the left atria of the heart, a third model illustrative of the heart valve to be replaced, and a fourth model illustrative of the ventricle of the valve to be replaced.

13. The system of claim 10, wherein the step of generating the display includes:

detecting the position of the tool within a view of a first model in the sequence;

illustrating a representation of the tool superimposed in spatial relation relative to the first model;

detecting the position of the tool within a field of view of a second model in the sequence; and

automatically removing the first model from the display and automatically illustrating the representation of the tool in spatial relation relative to the second model.

14. The system of claim 13, the generating the display step further comprising the steps of:

detecting the position of the tool within a field of view of a third model in the sequence; and

automatically removing the second model from the display and automatically illustrating the representation of the tool in spatial relation relative to the third model.

15. The system of claim 14, wherein the first, second and third models are arranged in accordance to a direction along the one of the selected pathways relative to one another.

16. The system of claim 10, wherein the sequence comprises a first model illustrative of a left atrium of the heart, a second model illustrative of the coronary sinus, and a third model illustrative of a circumflex coronary artery, and a fourth model illustrative of the mitral valve to be replaced.

17. The system of claim 10, wherein the sequence comprises a first model illustrative of the left or right illiac bifurcation, a second model illustrative of a aorta, a third model illustrative of both an aortic valve and a left ventricle, a fourth model illustrative of a mitral annulus, a mitral valve and a left atrium of the subject.

18. The system of claim 10, wherein the identifying step includes:

measuring a level of blockage along at least one of the plurality of pathways;

comparing a level blockage to a predetermined threshold to pass the tool through; and

selecting another of the plurality of pathways to pass the tool if the level of blockage exceeds the predetermined threshold.

19. A computer program product comprising a plurality of computer-readable program instructions for execution by a processor to track movement of a tool through a subject in percutaneous replacement of a heart valve of a subject, the plurality of computer-readable program instructions including:

identifying one of plurality of pathways to move the tool through a patient in percutaneous replacement of the heart valve;

identifying a sequence of graphical representations illustrative of the one of the plurality of pathways;

detecting the position of the tool within a threshold of one of the models in the sequence, and

generating a display including a representation of the tool superimposed relative to the model within the threshold.

20. The computer program product of claim 19, wherein the illustrating step includes:

detecting the position of the tool within a view of a first model in the sequence;

illustrating a representation of the tool superimposed in spatial relation relative to the first model;

detecting the position of the tool within a field of view of a second model in the sequence; and

automatically removing the first model from the display and automatically illustrating the representation of the tool in spatial relation relative to the second model.