Measurement of appendage openings

• US 9,668,674 B2
• Filed: 03/03/2015
• Issued: 06/06/2017
• Est. Priority Date: 03/03/2015
• Status: Active Grant

• Current Assignee: Transseptal Solutions Ltd.
• Original Assignee: Transseptal Solutions Ltd.
• Inventors: Sapir, Elad
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US14/636,759
• Publication Number:
  US 20160256075A1
• Time in Patent Office: 826 Days
• Field of Search: 600587
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2576/023 for the heart
• CPC Class Codes: A61B 5/0044 for the heart
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/1079 using optical or photographic means
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61F 2/2496 Devices for determining the dimensions of the prosthetic valve to be implanted, e.g. templates, sizers
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing

Abstract

Apparatus and methods are described, including a method for measuring an opening of an appendage of an atrium of a subject. A catheter is inserted into the atrium, and at least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The loop is used to measure the opening of the appendage. Other applications are also described.

Claims

1. A method for measuring an opening of an appendage of an atrium of a subject, the method comprising:

inserting a catheter into the atrium of the subject;

deploying at least one loop from a lateral wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter; and

using the loop to measure the opening of the appendage,

wherein measuring the opening comprises;

expanding the loop until the loop contacts at least two points on a perimeter of the opening; and

measuring a distance between the points, by using imaging to view the loop while it is in contact with the points.

2. The method according to claim 1, wherein the method comprises measuring an opening of an appendage of a left atrium of the subject.

3. The method according to claim 1, wherein deploying the loop comprises deploying the loop such that a normal to a plane defined by the loop intersects a line that is parallel to a longitudinal axis of the catheter at an angle that is between 10 and 90 degrees.

4. The method according to claim 1, wherein the method further comprises, before measuring the opening:

moving the distal end of the loop along a wall of the atrium; and

identifying the opening in response to the distal end of the loop reaching the opening.

5. The method according to claim 1, further comprising:

in response to the measuring, selecting an implant of an appropriate size;

delivering the implant to the opening, by passing the implant through the catheter; and

implanting the implant in the opening.

6. The method according to claim 1,

wherein the loop includes a longitudinal member that passes through a first opening and a second opening in the catheter wall, and

wherein deploying the loop comprises deploying the loop by passing the longitudinal member through at least one of the first and second openings.

7. The method according to claim 1, wherein deploying the at least one loop comprises deploying at least two loops.

8. The method according to claim 7, wherein deploying the at least two loops comprises deploying more than two loops.

10. The method according to claim 8,

wherein measuring the distance between the points further comprises using imaging to view the loop while it is in contact with the points.

9. A method for measuring an opening of an appendage of an atrium of a subject, the method comprising:

inserting a catheter into the atrium of the subject;

deploying at least one loop from a lateral wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter; and

using the loop to measure the opening of the appendage,

wherein measuring the opening comprises;

expanding the loop until the loop contacts at least two points on a perimeter of the opening; and

measuring a distance between the points, by utilizing a marker on a proximal portion of the loop that indicates an extent to which the loop has been expanded.

11. The method according to claim 9, wherein the method further comprises, before measuring the opening:

moving the distal end of the loop along a wall of the atrium; and

identifying the opening in response to the distal end of the loop reaching the opening.

12. A method for measuring an opening of an appendage of an atrium of a subject, the method comprising:

inserting a catheter into the atrium of the subject;

deploying at least one loop from a lateral wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter; and

using the loop to measure the opening of the appendage,

wherein the atrium is a left atrium,

wherein the loop is an appendage-finding and fossa-ovalis-finding loop, and

wherein the method further comprises, prior to inserting the catheter into the left atrium;

inserting the catheter into a right atrium of the subject;

deploying at least the loop from the lateral wall of the catheter;

moving the loop along an interatrial septum of the subject, until the loop contacts a fossa ovalis of the subject; and

in response to the loop contacting the fossa ovalis, puncturing the fossa ovalis by passing a puncturing element out of the distal end of the catheter.

13. The method according to claim 12, wherein the method further comprises, before measuring the opening:

moving the distal end of the loop along a wall of the atrium; and

identifying the opening in response to the distal end of the loop reaching the opening.

14. A method for measuring an opening of an appendage of a left atrium of a subject, the method comprising:

inserting a catheter into the atrium of the subject;

deploying at least one appendage-finding loop from a lateral wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter; and

using the appendage-finding loop to measure the opening of the appendage,

wherein the method further comprises, prior to inserting the catheter into the left atrium;

inserting the catheter into a right atrium of the subject;

deploying at least one fossa-ovalis-finding loop, which is different from the appendage-finding loop, from the lateral wall of the catheter;

moving the fossa-ovalis-finding loop along an interatrial septum of the subject, until the fossa-ovalis-finding loop contacts a fossa ovalis of the subject; and

in response to the fossa-ovalis-finding loop contacting the fossa ovalis, puncturing the fossa ovalis by passing a puncturing element out of the distal end of the catheter.

15. The method according to claim 14, wherein the method further comprises, before measuring the opening:

moving the distal end of the loop along a wall of the atrium; and

identifying the opening in response to the distal end of the loop reaching the opening.

16. A method for measuring an opening of an appendage of an atrium of a subject, the method comprising:

inserting a catheter into the atrium of the subject;

deploying at least one loop from a lateral wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter; and

using the loop to measure the opening of the appendage,

wherein measuring the opening of the appendage comprises measuring (a) a distance between a first pair of points on a perimeter of the opening, and (b) a distance between a second pair of points on the perimeter of the opening.

17. The method according to claim 16, wherein the method further comprises, before measuring the opening:

moving the distal end of the loop along a wall of the atrium; and

identifying the opening in response to the distal end of the loop reaching the opening.