System and workflow for diagnosing and treating septum defects

• US 20090292309A1
• Filed: 05/20/2008
• Published: 11/26/2009
• Est. Priority Date: 05/20/2008
• Status: Abandoned Application

• Current Assignee: Siemens AG
• Original Assignee: Siemens AG
• Inventors: Maschke, Michael
• Application Number:
  US12/154,053
• Publication Number:
  US 20090292309A1
• Time in Patent Office: Days
• US Class Current: 606/213
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 2017/00221 with wireless transmission of data, e.g. by infrared radiation or radiowaves
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal

Abstract

A system, method and workflow is described that may be used for the treatment of a patient having a cardiac syndrome characterized by an unwanted aperture in a structure of the heart. Images of the patient are obtained with a C-arm X-ray device, and the images are used to determine the size and location of the aperture. A catheter is used to insert an occluder into the patient and emplace the occluder in the aperture so as to close the aperture. The occluder may be guided using one of fluoroscopic images from the C-arm X-ray device, acoustic or magnetic sensors. Diagnosis of the syndrome and the minimally interventional treatment may be performed by the same treatment suite.

Claims

1. A method of treating cardiovascular syndromes, the method comprising:

positioning a patient in a therapy unit;

determining a size of an aperture between structures of a heart using a C-arm X-ray device; and

emplacing an occluder in the aperture using a catheter and guide wire.

2. The method of claim 1, wherein the patient is positioned by a robotic device.

3. The method of claim 1, further comprising determining the size of the aperture by measuring a size of a balloon containing radio-opaque material sufficient to close the opening.

4. The method of claim 3, wherein the step of measuring uses images obtained using the C-arm X-ray device.

5. The method of claim 1, further comprising determining the size of the aperture by processing C-arm X-ray data to produce CT-like images and segmenting the CT-like images to isolate a structure having the aperture.

6. The method of claim 5, wherein the CT-like images are synchronized with at least one of a cardiac cycle or a breathing cycle.

7. The method of claim 6, wherein the synchronization with the cardiac cycle is performed using electrocardiogram (EKG) data.

8. The method of claim 1, further comprising introducing the occluder into the heart using a catheter having a guide wire.

9. The method of claim 8, wherein a position of the occluder is determined by extracorporeal acoustic imaging.

10. The method of claim 8, wherein a position of the occluder is determined by a magnetic sensor.

11. A method of treating a patient, the method comprising:

providing a patient treatment suite, the suite further comprising;

a C-arm X-ray device, configured to produce CT-like 3 dimensional (3D) images or voxel data sets; and

a catheter suitable for introducing an occluder into a heart of the patient;

wherein the occluder is selected based on a measurement of a size of an aperture in the heart of the patient.

12. The method of claim 11, wherein act of measuring the size of the aperture uses an extracorporeal imaging modality.

13. The method of claim 12, wherein the extracorporeal imaging modality is one of the C-arm X-ray device or an acoustic imager.

14. The method of claim 12, wherein the size is a dimension of a balloon that occludes the aperture.

15. A workflow for treating a patient having a septum defect, the workflow comprising the steps of:

placing the patient on a patient support in a treatment unit;

inserting a catheter into the patient;

obtaining images of a heart of the patient using a C-arm X-ray device capable of recording data suitable for the production of CT-like images;

measuring a size of an unwanted aperture in the heart;

selecting an occluder based on the measured aperture size;

introducing the occluder into the patient using a catheter having a guide wire, and emplacing the occluder in the aperture;

detaching the occluder from the guide wire; and

removing the catheter from the patient.

16. The workflow of claim 15, wherein the measuring of the sizes further comprises:

using the catheter to position a balloon in the aperture, and inflating the balloon so that the balloon closes the aperture; and

measuring the diameter of the balloon with an imaging modality.

17. The workflow of claim 16, wherein the balloon is inflated with a radio-opaque material.

18. The workflow of claim 17, wherein the imaging modality is a C-arm X-ray device.

19. The workflow of claim 15, wherein the occluder is guided to the aperture using one of the C-arm X-ray device, an acoustic sensor, or a magnetic sensor.

20. The workflow of claim 15, wherein an image time is related to a cardiac cycle by electrocardiogram (EKG) information.

21. A system for treating a heart syndrome, comprising:

a imaging modality, configured to produce CT-like 3 dimensional (3D) images or voxel data sets; and

a catheter capable of introducing an occluder device into a heart of a patient;

wherein the occluder device is selected based on a measurement of a size of an aperture in the heart of the patient from the 3D images or voxel data sets.

22. The system of claim 21, wherein the imaging modality is a C-arm X-ray device.

23. The system of claim 21, wherein the imaging device is an extracorporeal acoustic imager.

24. The system of claim 21, wherein a position of the occluder is determined by extracorporeal acoustic imaging.

25. The system of claim 21, wherein a diagnosis of the syndrome and the introduction of the occluder is performed without moving the patient to another treatment room