Tissue visualization and manipulation systems

Abstract

Tissue visualization and manipulation systems are described herein. Such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. Additionally, any number of therapeutic tools can also be passed through the deployment catheter and into the imaging hood for treating the tissue region of interest.

1 . A method for accessing a tissue opening, comprising:
 intravascularly advancing a deployment catheter within a chamber of a heart filled with blood;   reconfiguring a barrier or membrane projecting from the deployment catheter within the chamber from a delivery configuration to a deployed configuration which defines an open field;   positioning the barrier or membrane over or upon a valve such that the valve is bounded at least in part within the open field; and,   extending an elongate bypass member from the catheter and through the valve such that a distal end of the bypass member projects past the valve.   
     
     
         2 . The method of  claim 1  further comprising introducing a transparent fluid into the open field such that blood is displaced from the valve. 
     
     
         3 . The method of  claim 2  further comprising visualizing the valve through the transparent fluid. 
     
     
         4 . The method of  claim 1  further comprising shunting blood through the bypass member from a first region proximal to the valve to a second region distal to the valve. 
     
     
         5 . The method of  claim 4  wherein shunting blood comprises passing the blood through at least one opening defined along the catheter proximal to the barrier or member and through at least one opening defined at or along a distal end of the bypass member. 
     
     
         6 . The method of  claim 4  wherein shunting blood further comprises controlling a direction of the blood flow via a one-way valve. 
     
     
         7 . The method of  claim 1  further comprising deploying a support flap from a low-profile shape to a deployed shape distal to the valve. 
     
     
         8 . The method of  claim 1  further comprising treating the valve bounded at least in part within the open field. 
     
     
         9 . The method of  claim 8  wherein treating comprises treating a mitral valve. 
     
     
         10 . The method of  claim 1  wherein intravascularly advancing the barrier or membrane comprises advancing the deployment catheter intravascularly into a left atrial chamber of the heart. 
     
     
         11 . The method of  claim 1  wherein reconfiguring comprises deploying the barrier or membrane into a conical structure which defines the open field. 
     
     
         12 . A valve tissue treatment system, comprising:
 a deployment catheter having a barrier or membrane projecting from a distal end of the catheter, the barrier or membrane being reconfigurable between a delivery configuration and a deployed configuration which defines an open field; and,   an elongate bypass member which is translatable through the open field and beyond the barrier or membrane,   wherein an opening defined near or at a distal end of the bypass member is in fluid communication through the bypass member with one or more openings defined along the catheter proximal to the barrier or membrane.   
     
     
         13 . The system of  claim 12  wherein the open field is sized for placement over or upon a valve positioned within a heart. 
     
     
         14 . The system of  claim 12  further comprising at least one imaging element positioned within or along the barrier or membrane for visualizing within the open field. 
     
     
         15 . The system of  claim 12  wherein the bypass member further comprises a tissue attachment member. 
     
     
         16 . The system of  claim 12  wherein the barrier or membrane forms a conical shape in its deployed configuration. 
     
     
         17 . The system of  claim 16  wherein the barrier or membrane forms a conical shape which is off-center relative to the catheter. 
     
     
         18 . The system of  claim 12  further comprising a fluid reservoir in communication through the catheter with the open field. 
     
     
         19 . The system of  claim 12  further comprising a one-way valve within the catheter or bypass member for controlling a direction of flow therethrough. 
     
     
         20 . The system of  claim 12  further comprising a support flap attached to the bypass member and deployable from a low-profile shape to a deployed shape distal to the barrier or membrane. 
     
     
         21 . The system of  claim 12  further comprising an instrument deliverable through the catheter and into the open field. 
     
     
         22 . A method for imaging a tissue region, comprising:
 intravascularly advancing a deployment catheter within a chamber of a heart filled with blood;   reconfiguring a barrier or membrane projecting from the deployment catheter within the chamber from a delivery configuration to a deployed configuration which defines an open field;   positioning the barrier or membrane adjacent to or against an annulus of a valve to be visualized such that a portion of the annulus is bounded within the open field;   introducing a transparent fluid into the open field such that blood is displaced therefrom; and   visualizing the portion of the annulus through the transparent fluid.   
     
     
         23 . The method of  claim 22  wherein intravascularly advancing the barrier or membrane comprises advancing the deployment catheter intravascularly into a left atrial chamber of the heart. 
     
     
         24 . The method of  claim 22  wherein reconfiguring comprises deploying the barrier or membrane into a conical structure which defines the open field. 
     
     
         25 . The method of  claim 22  wherein positioning comprises steering the deployment catheter within the chamber to the annulus. 
     
     
         26 . The method of  claim 22  wherein introducing comprises pumping the transparent fluid into the open field through a fluid delivery lumen defined through the deployment catheter. 
     
     
         27 . The method of  claim 22  wherein introducing comprises pumping saline, plasma, water, or perfluorinated liquid into the barrier or membrane. 
     
     
         28 . The method of  claim 22  wherein visualizing comprises wirelessly transmitting data received from the portion of the annulus. 
     
     
         29 . The method of  claim 22  wherein visualizing comprises illuminating the portion of the annulus. 
     
     
         30 . The method of  claim 22  wherein visualizing comprises recording an image of the portion of the annulus. 
     
     
         31 . The method of  claim 22  further comprising repositioning the barrier or membrane along a second portion of the annulus to be visualized. 
     
     
         32 . The method of  claim 22  further comprising treating the portion of the annulus with a therapeutic tool advanced through the deployment catheter. 
     
     
         33 . The method of  claim 22  further comprising sensing a physical parameter within or outside the barrier or membrane. 
     
     
         34 . The method of  claim 22  further comprising deploying an anchoring assembly into the portion of the annulus. 
     
     
         35 . A method for imaging an annulus of a mitral valve, comprising:
 intravascularly advancing a deployment catheter within a left atrial chamber of a heart filled with blood;   deploying a barrier or membrane projecting from the deployment catheter from a low-profile configuration to an expanded configuration;   positioning an open field defined by the barrier or membrane adjacent to or against a portion of an annulus of a mitral valve such that the portion is bounded within the open field; and   displacing blood from the open field via a transparent fluid introduced through the deployment catheter.   
     
     
         36 . The method of  claim 35  further comprising visualizing the portion of the annulus through the transparent fluid. 
     
     
         37 . The method of  claim 36  wherein visualizing comprises wirelessly transmitting data received from the portion of the annulus. 
     
     
         38 . The method of  claim 35  wherein intravascularly advancing the barrier or membrane comprises advancing the deployment catheter transseptally into the left atrial chamber. 
     
     
         39 . The method of  claim 35  wherein deploying comprises deploying the barrier or membrane into a conical structure which defines the open field. 
     
     
         40 . The method of  claim 35  wherein positioning comprises steering the deployment catheter within the chamber to the annulus. 
     
     
         41 . The method of  claim 35  wherein displacing comprises pumping the transparent fluid into the open field through a fluid delivery lumen defined through the deployment catheter. 
     
     
         42 . The method of  claim 35  further comprising repositioning the barrier or membrane along a second portion of the annulus to be visualized. 
     
     
         43 . The method of  claim 35  further comprising treating the portion of the annulus with a therapeutic tool advanced through the deployment catheter. 
     
     
         44 . The method of  claim 35  further comprising sensing a physical parameter within or outside the barrier or membrane. 
     
     
         45 . The method of  claim 35  further comprising deploying an anchoring assembly into the portion of the annulus.