System and Method Using Forward Looking Imaging for Valve Therapies

• US 20130289391A1
• Filed: 04/26/2013
• Published: 10/31/2013
• Est. Priority Date: 04/27/2012
• Status: Abandoned Application

• Current Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Original Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Inventors: Levy, Oren, Park, Byong-Ho, Bowden, Russell W., Ho, Dietrich, Thomas, Stan
• Application Number:
  US13/871,533
• Publication Number:
  US 20130289391A1
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/085 for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• CPC Class Codes: A61B 8/0891 for diagnosis of blood vessels
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61B 8/4461 Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
• CPC Class Codes: A61B 8/461 Displaying means of special interest
• CPC Class Codes: A61B 8/483 involving the acquisition of a 3D volume of data

Abstract

A system is provided for aortic valve imaging utilizing forward looking imaging sensors. A method of imaging the aortic valve is provided that can be utilized for diagnostic evaluation and the delivery of a therapy. In one form, the imaging system can be used to place a replacement aortic valve. In another aspect, an imaging system is combined with a valve replacement delivery system.

Claims

1. A medical method, comprising:

positioning a guidewire and a forward looking imaging device in the vasculature of a patient;

advancing the guidewire and forward looking imaging device to a position adjacent the aortic valve;

imaging the aortic valve with the forward looking imaging device to obtain a valve image and determine properties of the valve;

crossing the aortic valve with at least a distal portion of the guidewire utilizing the valve image.

2. The method of claim 1, wherein said imaging includes imaging tissue positioned distally beyond a distal tip of the guidewire.

3. The method of claim 1, wherein the valve image is an axial image of the valve.

4. The method of claim 1, wherein said advancing includes advancing along a first path, the method further including determining a second path based on the valve image and aligning a least a distal tip of the guidewire with the second path and said crossing includes advancing the distal tip along the second path.

5. The method of claim 4, wherein the first path defines a first longitudinal axis for at least the distal tip and said aligning includes rotating or moving the distal tip laterally away from the first longitudinal axis.

6. The method of claim 1, wherein the advancing includes positioning the forward looking imaging device in the superior vena cava oriented to view the aortic valve.

7. The method of claim 1, wherein the advancing includes positioning the forward looking imaging device in the right atrium oriented to view the aortic valve.

8. The method of claim 1, wherein the advancing includes positioning the forward looking imaging device within the aorta oriented to view the aortic valve.

9. The method of claim 1, wherein the properties include a determination of the distance from the coronary ostia.

10. The method of claim 1, wherein the properties include a determination of the annulus shape and diameter.

11. The method of claim 1, wherein the properties include an evaluation of calcium deposits on the aortic valve.

12. The method of claim 1, wherein the imaging includes developing three dimensional properties of the aortic valve.

13. The method of claim 1, further including advancing to a second location to generate a second set of images of the aortic valve and viewing a comparison of the first set of images from the first location to the second set of images from the second location.

14. The method of claim 13, further including synchronizing the images viewed with a certain portion of the heartbeat.

15. The method of claim 13, further including utilizing the forward looking imaging device to evaluate blood flow adjacent the aortic valve.

16. The method of claim 15, wherein said evaluating includes evaluation of regurgitation of blood through the aortic valve.

17. The method of claim 15, wherein said evaluating includes evaluation of the blood flow through the coronary ostium.

18. The method of claim 15, wherein said utilizing includes visualizing a colorized image to evaluate blood flow.

19. The method of claim 1, wherein the imaging device has a distal end defining an imaging plane, further including deflecting the distal end in a first direction to locate the valve major axis and deflecting the image plane in a second direction to locate the valve minor axis.

20. A medical method, comprising:

positioning a forward looking imaging device in the vasculature of a patient;

advancing the forward looking imaging device into the aorta adjacent the natural aortic valve;

imaging the natural aortic valve with the forward looking imaging device to obtain a valve image and determine properties of the natural aortic valve;

placing an unexpanded replacement valve in the annulus of the natural aortic valve utilizing the valve image; and

imaging the position of the unexpanded replacement valve.

21. The method of claim 20, further including repositioning the unexpanded replacement valve within the natural aortic valve annulus in response to imaging the position of the unexpanded replacement valve.

22. The method of claim 20, further including visualizing the deployment of the replacement valve within the natural aortic valve annulus and evaluating the placement of the replacement valve.

23. The method of claim 22, wherein said evaluating includes viewing an image of blood flow through the replacement valve to consider leakage between the replacement valve and the aortic valve annulus.

24. The method of claim 23, wherein the image of blood flow through the replacement valve includes blood flow during systole to allow visualization of blood flow in the wrong direction.

25. The method of claim 22, wherein the method further includes utilizing the imaging device to take hemodynamic measurements following deployment of the replacement valve.

26. A system, comprising:

a processor configured to receive imaging signals from an aortic imaging device;

a visual display;

a delivery catheter including;

a prosthetic valve positioned adjacent a distal end; and

a forward looking imaging device positioned adjacent said prosthetic valve, wherein said imaging device is positioned to image tissue extending distally beyond said valve and generates image signals; and

a connection between said forward looking imaging device and said processor, said connection providing said image signals to said processor.

27. The system of claim 26, wherein said imaging device is placed proximal of the prosthetic valve along the delivery catheter.

28. The system of claim 26, wherein said processor is configured to display an image of the aortic valve with an indication of the best pathway through the valve and an indication of current image device alignment in relation to the best pathway.

29. The system of claim 26, further including a second forward imaging device sized for placement in the right atrium, said second imaging device generating second image signals, said processor receiving said second image signals and configured to generate a second image based on said second signals.

30. The system of claim 29, wherein said processor is further configured to generate a three dimensional image of at least a portion of the aortic valve based on input from said first and second image signals.