Method and apparatus for locating the fossa ovalis, creating a virtual fossa ovalis and performing transseptal puncture

Abstract

Apparatus is provided of locating the fossa ovalis in a patient by locating at least one of the His bundle, the plane of the interatrial septum, and the coronary sinus ostium in a patient, and thereafter locating the fossa ovalis on the basis of one or more predetermined distances between these locations. Software is also provided that can determine and display the location of the fossa ovalis in a patient based on predetermined distances between the locations. Such software can for example be provided within an electroanatomical system. Methods of determining the location of the fossa ovalis, performed by either a clinician or a central processing unit-controlled surgical system, are also provided and determined using predetermined measurements from defined locations. An apparatus for locating the fossa ovalis and performing a transseptal puncture is also provided.

1 . A medical device comprising:
 a hollow catheter comprising a hollow lumen terminating at a distal end; and   means for determining a position of the hollow catheter by an electroanatomical navigation system,   wherein the means for determining a position comprises one of: an impedance-measuring electrode element, an acoustic-ranging system element, and a computed tomography imaging element,   wherein the hollow catheter is navigable through a patient's vasculature, wherein said hollow lumen is adapted to receive a second medical device having a length greater than that of the hollow catheter.   
     
     
         2 . A medical device according to  claim 1 , wherein the means for determining a position further comprises a magnetic field sensor element. 
     
     
         3 . A medical device according to  claim 1 , wherein the second medical device comprises a transseptal needle and further comprising:
 means for advancing and retracting said transseptal needle through the hollow lumen to an extent that a distal tip of the transseptal needle protrudes beyond the distal end of the hollow catheter.   
     
     
         4 . A medical device according to  claim 1 , wherein the means for determining a position further comprises a display screen 
     
     
         5 . A medical device according to  claim 4 , wherein the display screen is configured for displaying a visual representation of a three-dimensional location of at least a distal portion of one or more catheters 
     
     
         6 . A medical device according to  claim 1 , wherein the distal end of the hollow catheter is tapered 
     
     
         7 . A medical device according to  claim 1 , wherein the electroanatomical navigation system couples to at least one element comprising: a transseptal needle element; an impedence-measuring electrode element; and an acoustic-ranging system element, and
 wherein the at least one element couples to the hollow catheter.   
     
     
         8 . A medical device according to  claim 1  further comprising a first electrode coupled to the distal end of the hollow catheter. 
     
     
         9 . A medical device according to  claim 8  further comprising a second electrode coupled to the hollow catheter spaced apart from the first electrode. 
     
     
         10 . A medical device according to  claim 9 , wherein the distal end of the hollow catheter is tapered and the first electrode and the second electrode are spaced apart a distance between about 2 mm and about 4 mm 
     
     
         11 . A medical device comprising:
 a hollow catheter adapted to navigate a patient's vasculature to the right atrium, wherein the hollow catheter surrounds a hollow lumen terminating at a distal end; and   means for determining a position of the hollow catheter by an electroanatomical navigation system;   wherein the means for determining a position comprises one of: an impedance-measuring electrode element, an acoustic-ranging system element, and a computed tomography imaging element,   wherein said hollow lumen is configured to receive a second medical device therethrough   
     
     
         12 . A medical device according to  claim 11 , wherein the means for determining a position further comprises a magnetic field sensor element. 
     
     
         13 . A medical device according to  claim 11 , wherein the second medical device comprises a transseptal needle and further comprising:
 means for advancing and retracting said transseptal needle through the hollow lumen to an extent that a distal tip of the transseptal needle protrudes beyond the distal end of the hollow catheter.   
     
     
         14 . A medical device according to  claim 11  further comprising a first electrode coupled to the distal end of the hollow catheter. 
     
     
         15 . A medical device according to  claim 14  further comprising a second electrode coupled to the hollow catheter and spaced apart from the first electrode. 
     
     
         16 . An apparatus comprising:
 a hollow catheter comprising a hollow lumen terminating at a distal end, wherein said hollow lumen is adapted to receive a second medical device having a length greater than that of the hollow catheter; and   an electroanatomical navigation system element, said electroanatomical navigation system element configured for determining the relative position of at least a distal portion of the hollow catheter   wherein the electroanatomical navigation system element comprises one of: an impedance-measuring electrode element, an acoustic-ranging system element, and a computed tomography imaging element.   
     
     
         17 . An apparatus according to  claim 16 , wherein the electroanatomical navigation system element further comprises a magnetic field sensor element. 
     
     
         18 . An apparatus according to  claim 16 , wherein the second medical device comprises a transseptal needle and further comprising:
 means for advancing and retracting said transseptal needle through the hollow lumen to an extent that a distal tip of the transseptal needle protrudes beyond the distal end of the hollow catheter.   
     
     
         19 . An apparatus according to  claim 16 , wherein the electroanatomical navigation system comprises a display screen, wherein said display screen is configured for displaying a visual representation of the three-dimensional location of a distal portion of one or more catheters 
     
     
         20 . An apparatus according to  claim 16  further comprising:
 a first electrode coupled to the distal end of the hollow catheter; and 
 a second electrode coupled to the hollow catheter and spaced apart from the first electrode.