Systems and methods for anatomical feature determination

Abstract

To provide systems and methods for anatomical feature determination.SOLUTION: Techniques for determining a position of a native leaflet within a cardiac vessel can include identifying a position of mineral formation on the native leaflet before implantation of a prosthetic valve, and analyzing an image representing the prosthetic valve implanted within the cardiac vessel. The analysis can identify a position of mineral formation within the cardiac vessel after the prosthetic valve is implanted. Based on the position of the mineral formation on the native leaflet before implantation of the prosthetic valve and the position of the mineral formation within the cardiac vessel, a position of the native leaflet within the cardiac vessel can be determined.SELECTED DRAWING: Figure 7

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Application No. 62 / 970,110, filed February 4, 2020, and entitled "SYSTEMS AND METHODS FOR ANATOMICAL FEATURE DETERMINATION," the entire contents of which are incorporated herein by reference.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates to the field of medical devices and procedures. [Background technology]

[0003] Aortic valve calcification occurs when calcium deposits form on the aortic valve of the heart. The calcium deposits can cause the aortic valve to narrow and / or stiffen at the opening. If the calcification becomes severe, the aortic valve is unable to open and close properly, affecting blood flow through the valve, a condition called aortic stenosis. In some cases of aortic valve calcification or stenosis, the aortic valve needs to be replaced with a prosthetic valve. Summary of the Invention [Problem to be solved by the invention]

[0004] One or more methods and / or systems for determining anatomical features are described herein. In some aspects, the present disclosure relates to methods and systems for determining access for anatomical features based on analysis of one or more images representing mineral deposits. [Means for solving the problem]

[0005] In some embodiments, the present disclosure relates to a method for determining the position of a native valve leaflet. The method can include acquiring a pre-treatment image representing a native valve within a cardiac vessel and analyzing the pre-treatment image to determine the location of mineral deposits on the native valve leaflets. The method can also include acquiring, by a control circuit, a post-treatment image representing a prosthetic valve implanted over the native valve and analyzing the post-treatment image to identify the location of the mineral deposits within the cardiac vessel. Further, the method can include determining, by the control circuit, the location of the native valve leaflet within the cardiac vessel. The location of the native valve leaflet can be determined based at least in part on the location of the mineral deposits on the native valve leaflet and the location of the mineral deposits within the cardiac vessel. In some implementations, the native valve includes an aortic valve, and the cardiac vessel includes an aorta.

[0006] In some implementations, the method further includes determining access to a fluid vessel associated with the cardiac vessel based at least in part on the position of the native valve leaflets within the cardiac vessel. In some implementations, the method further includes identifying a position of at least a portion of a prosthetic valve within the cardiac vessel based at least in part on analysis of the post-procedure images. Determining access to a fluid vessel may be based at least in part on the position of at least a portion of the prosthetic valve within the cardiac vessel. Further, in some embodiments, the method further includes identifying a position of a coapted valve leaflet within the cardiac vessel based at least in part on analysis of the pre-procedure images, determining an edge of the native valve leaflet based at least in part on the position of the coapted valve leaflet, and determining a distance between the edge of the native valve leaflet and a mineral deposit. Determining access to a fluid vessel may be based at least in part on the distance between the edge of the native valve leaflet and a mineral deposit.

[0007] In some implementations, analyzing the pre-treatment images to identify locations of mineral deposits on the native valve leaflets may include generating user interface data representing the pre-treatment images, providing the user interface data to a display device, receiving input regarding the mineral deposits, and identifying the locations of the mineral deposits based at least in part on the input. Further, in some implementations, analyzing the pre-treatment images to identify locations of mineral deposits on the native valve leaflets may include performing one or more image processing techniques using the pre-treatment images to identify locations of mineral deposits on the native valve leaflets.

[0008] In some embodiments, the present disclosure relates to a computing system including a control circuit and a memory communicatively coupled to the control circuit and storing executable instructions that, when executed by the control circuit, cause the control circuit to perform operations. The operations can include receiving data indicating locations of mineral formations on native leaflets of a native valve within a cardiac vessel, generating graphical interface data representing an image of a prosthetic valve implanted on the native valve, receiving input regarding locations of the mineral representations within the image, and determining locations of the native valve leaflets within the cardiac vessel based at least in part on the input and the data. In some embodiments, the image includes at least one of a computed tomography image or an x-ray image of the cardiac vessel.

[0009] In some implementations, the native valve includes an aortic valve and the cardiac vessel includes an aorta. In some embodiments, the operations further include determining an amount of coronary artery access based at least in part on a position of the native valve cusp within the cardiac vessel. Further, in some embodiments, the operations further include identifying a position of at least a portion of a prosthetic valve within the aorta. Determining the amount of coronary artery access may be based at least in part on a position of at least a portion of the prosthetic valve within the aorta.

[0010] In some implementations, the data indicates a location of the mineral formation relative to the ends of the native valve leaflets, and determining the location of the native valve leaflets within the cardiovascular vessel is based at least in part on the location of the mineral formation relative to the ends of the native valve leaflets. Further, in some implementations, the data indicates one or more characteristics of the mineral formation, and the operations further include performing one or more image processing techniques using the image to determine, based at least in part on the data, that a mineral representation in the image represents mineral formation on the native valve leaflets.

[0011] In some embodiments, the present disclosure relates to a method, the method including acquiring, by a control circuit, an image representing a prosthetic valve implanted on a native valve within a cardiac vessel, and receiving, by the control circuit, data indicating a location of mineral formation on the native valve leaflets prior to implantation of the prosthetic valve. The method may also include analyzing the image to identify a location of mineral formation within the cardiac vessel, and determining a location of the native valve leaflets within the cardiac vessel based at least in part on the location of the mineral representation and the data.

[0012] In some implementations, the method further includes determining an amount of access to a fluid vessel associated with the cardiac vessel based at least in part on the position of the native valve leaflets within the cardiac vessel. In some embodiments, the method further includes identifying a position of at least a portion of a prosthetic valve within the aorta. Determining the amount of access to a fluid vessel may be based at least in part on the position of at least a portion of the prosthetic valve within the cardiac vessel. Further, in some embodiments, the method further includes identifying a position of a coapted valve leaflet within the cardiac vessel, determining an edge of the native valve leaflet based at least in part on the position of the coapted valve leaflet, and determining a distance between the edge of the native valve leaflet and a mineral formation. Determining the amount of access to a fluid vessel may be based at least in part on the distance between the edge of the native valve leaflet and a mineral formation.

[0013] In some implementations, the data indicates a location of the mineral formation relative to the ends of the native valve leaflets. Determining the location of the native valve leaflets within the cardiac vessel may be based at least in part on the location of the mineral formation relative to the ends of the native valve leaflets. Further, in some implementations, analyzing the image to identify a location of the mineral deposits within the cardiac vessel includes performing one or more image processing techniques using the image to identify a location of the mineral formation within the cardiac vessel.

[0014] In some embodiments, the present disclosure relates to a method, the method including analyzing a first image to determine a location of mineral deposits on a native valve leaflet within a cardiac vessel and analyzing a second image to identify a location of the mineral deposits within the cardiac vessel. The first image may represent a native valve, and the second image may represent a prosthetic valve. The method may also include determining coronary access based at least in part on the location of the mineral deposits on the native valve leaflet and the location of the mineral deposits within the cardiac vessel, and providing an indication indicating coronary access status. The indication may be based at least in part on the determined coronary access. In some implementations, the indication indicates a risk level associated with performing a procedure that includes accessing the coronary arteries.

[0015] In some implementations, the indication indicates an amount of coronary artery access. In some embodiments, the method further includes determining that the amount of coronary artery access is less than a threshold and refraining from performing a procedure involving coronary artery access based at least in part on determining that the amount of coronary artery access is less than a threshold. Further, in some embodiments, the method further includes determining that the amount of coronary artery access is greater than a threshold and performing a procedure involving coronary artery access based at least in part on determining that the amount of coronary artery access is greater than a threshold.

[0016] For purposes of summarizing the present disclosure, certain aspects, advantages, and novel features have been described. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, the disclosed embodiments may be practiced in a manner that achieves or optimizes one advantage or advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.

[0017] Various embodiments are illustrated in the accompanying drawings for purposes of illustration and should not be construed as limiting the scope of the present disclosure. In addition, various features of different disclosed embodiments may be combined to form additional embodiments that are part of the present disclosure. Throughout the drawings, reference numerals may be reused to indicate correspondence between referenced elements. [Brief explanation of the drawings]

[0018] [Figure 1] FIG. 1 is a perspective view of an exemplary heart in accordance with one or more embodiments. [Figure 2] FIG. 1 is a cross-sectional top view of an exemplary heart in accordance with one or more embodiments. [Figure 3] FIG. 1 is a cross-sectional view of an exemplary heart having mineral formation on an aortic valve, according to one or more embodiments. [Figure 4] 4 is an illustrative cross-sectional view of the heart of FIG. 3 with a prosthetic valve implanted in the aortic valve, according to one or more embodiments. [Figure 5] 1 is an exemplary architecture for determining access to an anatomical feature based on analysis of one or more images representing mineral deposits, according to one or more embodiments. [Figure 6] 1A-1C are cross-sectional views of exemplary native valve leaflets and mineral formations, according to one or more embodiments. [Figure 7] 1A-1C are cross-sectional views of an exemplary native valve leaflet, mineral formation, and prosthetic valve, according to one or more embodiments. [Figure 8A]FIG. 10 is an example flow diagram of a process for analyzing one or more images to determine the location / characteristics of anatomical features, according to one or more embodiments. [Figure 8B] FIG. 10 is an example flow diagram of a process for analyzing one or more images to determine the location / characteristics of anatomical features, according to one or more embodiments. [Figure 9] FIG. 10 is an example flow diagram of a process for providing an interface for determining the location / characteristics of an anatomical feature, according to one or more embodiments. [Figure 10] 1 is an exemplary image of a cardiac vessel prior to implantation of a prosthetic valve, according to one or more embodiments. [Figure 11] 1 is an exemplary image of a cardiac vessel after implantation of a prosthetic valve, according to one or more embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0019] The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed subject matter.The present disclosure relates to systems, devices, and methods for determining access for anatomical features based on analysis of one or more images representing mineral deposits.

[0020] Although several preferred embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as modifications and equivalents thereof. Accordingly, the scope of the claims that may arise herefrom is not limited by any of the specific embodiments described below. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as multiple separate operations in a manner that may be helpful in understanding some embodiments, but the order of description should not be construed to imply that these operations are order dependent. Additionally, the structures, systems, and / or devices described herein may be embodied as integrated or separate components. For purposes of comparing various embodiments, some aspects and advantages of these embodiments will be discussed. Not necessarily all such aspects or advantages are achieved by any particular embodiment. Thus, for example, various embodiments may be performed in a manner that achieves or optimizes one advantage or advantages as taught herein, without necessarily achieving other aspects or advantages as may be taught or suggested herein.

[0021] The term "associated with" is used herein in accordance with its broad and ordinary meaning. For example, when a first feature, element, component, device, or member is described as being "associated with" a second feature, element, component, device, or member, such description should be understood to indicate that the first feature, element, component, device, or member is physically coupled, attached, connected, integrated with, at least partially incorporated within, or otherwise physically associated with, whether directly or indirectly, the second feature, element, component, device, or member.

[0022] overview As mentioned above, in some cases of aortic valve calcification or stenosis, it is necessary to replace the aortic valve with a prosthetic valve. Implantation of a prosthetic heart valve can involve delivering a prosthetic valve to the native valve and deploying the prosthetic valve relative to the valve and / or surrounding anatomical structures. For example, when a prosthetic valve is implanted into the aortic valve, the valve's native cusps are displaced toward the aortic wall and surrounding anatomical structures. In some cases, one or more native valve cusps may completely or partially block the coronary artery ostia, blocking access to the coronary arteries. In the future, access to the coronary arteries may be required to perform other procedures on the heart or surrounding anatomical structures (sometimes referred to as "re-access procedures"). For example, in some re-access procedures, a physician may navigate a device, such as a scope or catheter, through the aorta to the aortic valve and attempt to move it into the coronary arteries through the coronary artery ostia. However, the physician may not realize that the native valve cusps have been displaced by the prosthetic valve to the extent that they are blocking access to the coronary arteries. Such a blockage may result in an unsuccessful re-access procedure and / or a failure to perform the re-access procedure, given the likelihood of success.

[0023] The present disclosure describes techniques and systems for determining access for anatomical features based on analysis of one or more images depicting mineral deposits. In some embodiments, the techniques can estimate the position of a native valve after a prosthetic valve has been implanted therein. For example, the techniques can analyze pre-treatment images of the native valve to determine the location of mineral deposits on the native valve leaflets, such as calcium deposits on the native valve leaflets. Following implantation of the prosthetic valve, the techniques can analyze post-treatment images of the prosthetic valve to identify the location of mineral deposits within the heart valve area. Based on the location of the mineral deposits on the native valve leaflets (as determined from the pre-treatment images) and the location of the mineral deposits within the heart valve area (as identified from the post-treatment images), the techniques can estimate the location of the native valve leaflets after implantation of the prosthetic valve. Such information can be used to determine the amount of access (e.g., available space) for blood vessels located proximate to the native valve, such as the coronary arteries.

[0024] In many embodiments, the techniques and systems are discussed in the context of calcium and / or phosphate formation on valves, such as in the case of aortic calcification / stenosis, however, the techniques and systems can be applied to a variety of situations, such as other mineral and / or anatomical features.

[0025] Exemplary cardiac anatomy 1 and 2 illustrate an exemplary heart 100 having various features relevant to certain aspects of the present disclosure. In particular, FIG. 1 illustrates a perspective view of the heart 100, and FIG. 2 illustrates a cross-sectional top view of the heart 100. The heart 100 includes four chambers: a left ventricle 102, a left atrium 104, a right ventricle 106, and a right atrium 108. A muscular wall, called the septum, separates the left chamber from the right chamber. In particular, the interatrial septum wall portion separates the left atrium 104 from the right atrium 108, while the interventricular septum wall portion separates the left ventricle 102 from the right ventricle 106. The lower end 110 of the heart 100, called the apex, is generally located on or near the midclavicular line in the fifth intercostal space.

[0026] The heart 100 includes four valves to aid in the circulation of blood therethrough. A heart valve may generally include a relatively dense fibrous ring, referred to herein as the annulus, as well as multiple leaflets or cusps attached to the annulus. Generally, the leaflets or cusps may be sized and positioned such that, when the heart contracts, the resulting increased blood pressure generated within the corresponding heart chamber forces the leaflets at least partially open, allowing flow from the heart chamber. When pressure within a heart chamber decreases, pressure within a subsequent heart chamber or blood vessel may prevail and push the leaflets back. As a result, the leaflets / cusps appose each other, thereby closing the flow path.

[0027] Surrounding the ventricles (102, 106) are numerous arteries 112 (sometimes called "coronary arteries 112") that supply oxygenated blood to the heart muscle, and numerous veins (not shown) that return blood from the heart muscle to the right atrium 108 via the coronary sinus, a relatively large vein that extends generally around the top of the left ventricle 102 and provides a return conduit for blood returning to the right atrium 108.

[0028] The left ventricle 102 is the primary pumping chamber of the heart 100. A healthy left ventricle is generally longer (relative to a transverse axis extending at its widest point between the opposing walls of the left ventricle 102) than it is wide (relative to the mean electrical axis of the heart 100) and is generally conical or apical in shape, in that its cross-sectional diameter and / or circumference decrease from the base 114 down to the point or apex 110. Generally, the apical region of the heart 100 can be considered the bottom region of the heart 100, located within the left and / or right ventricular regions, but distal to the mitral valve 202 and tricuspid valve 204, and disposed toward the apex 110 of the heart.

[0029] Pumping of blood from the left ventricle 102 is accomplished by squeezing and twisting, or torsional, motions. The squeezing motion occurs between the lateral wall of the left ventricle 102 and the septum. The twisting motion is the result of contraction of myocardial fibers that extend in a roughly circular or spiral direction around the heart 100. As these fibers contract, a gradient of angular displacement of the myocardium from the apex 110 to the base 114 about the mean electrical axis of the heart 100 is produced. The resultant force vector extends at an angle of approximately 30 to 60 degrees relative to the flow of blood through the aortic valve 208 and the ascending aorta 116. Contraction of the heart 100 manifests as a counterclockwise rotation of the apex 110 relative to the base 114 when viewed from the apex 110 (i.e., a bottom view of the heart 100). Contractions of the heart 100, in conjunction with the filling volumes of the left atrium 104 and ventricle 102, respectively, can result in relatively high fluid pressures on the left side of the heart 100, at least during certain phases of the cardiac cycle.

[0030] The primary role of the chambers on the left side of the heart 100 (i.e., the left atrium 104 and the left ventricle 102) is to serve as a holding chamber for blood returning from the lungs (not shown) and as a pump to transport blood to other regions of the heart 100. The left atrium 104 receives oxygenated blood from the lungs via the pulmonary veins. Oxygenated blood collected from the pulmonary veins in the left atrium 104 enters the left ventricle 102 through the mitral valve 202. In some patients, the walls of the left atrium 104 are slightly thicker than the walls of the right atrium 108. Deoxygenated blood enters the right atrium 108 through the inferior vena cava 118 and superior vena cava 120. The right side of the heart 100 (i.e., the right atrium 108 and the right ventricle 106) then pumps this deoxygenated blood into the pulmonary artery 120 around the lungs. There, fresh oxygen enters the bloodstream, and the blood travels to the left side of the heart 100 via a network of pulmonary veins that ultimately terminate in the left atrium 104. In FIG. 1, a portion of the pulmonary trunk has been removed (ie, shown by the dotted line) to expose the left coronary artery 112(A).

[0031] The valves of the heart 100 include a tricuspid valve 204 that separates the right atrium 108 from the right ventricle 106. The tricuspid valve 204 may generally have three valve points or leaflets and may generally close during ventricular contraction (i.e., systole) and open during ventricular expansion (i.e., diastole). The valves of the heart 100 further include a pulmonary valve 206 that separates the right ventricle 106 from the pulmonary artery 120. The pulmonary valve 206 may be configured to open during systole to allow blood to be pumped toward the lungs and close during diastole to prevent blood from leaking from the pulmonary artery 120 back into the heart 100. The pulmonary valve 206 generally has three cusps / leaflets, each of which may have a crescent shape. The heart 100 also includes a mitral valve 202, which generally has two cusps / leaflets and separates the left atrium 104 from the left ventricle 102. The mitral valve 202 may generally be configured to open during diastole to allow blood in the left atrium 104 to flow into the left ventricle 102 and close during systole to prevent blood from leaking back into the left atrium 104. The heart 100 further includes an aortic valve 208 that separates the left ventricle 102 from the aorta 116. The aortic valve 208 generally has three cusps / leaflets, each of which may have a crescent shape. The aortic valve 208 is configured to open during systole to allow blood exiting the left ventricle 102 to enter the aorta 116 and close during diastole to prevent blood from leaking back into the left ventricle 102.

[0032] Atrioventricular (i.e., mitral and tricuspid) heart valves are generally associated with a subvalvular apparatus that includes a collection of chordae tendineae and papillary muscles that secure the leaflets of each valve to promote and / or facilitate proper coaptation of the leaflets and prevent their prolapse. For example, the papillary muscles may generally include finger-like projections from the ventricular wall. The chordae tendineae generally prevent the leaflets from opening in the wrong direction, thereby preventing blood from backflowing into the left atrium 104.

[0033] With further reference to the aortic anatomy of the heart 100, the ascending aorta generally originates at the opening of the aortic valve 208 within the left ventricle 102 of the heart. The ascending aorta may pass through a pericardial sheath common with the pulmonary trunk. At the root of the ascending aorta, the vessel lumen may generally present three relatively small pockets (i.e., the aortic sinuses or "sinuses of Valsalva") between the cusps of the aortic valve 208 and the wall of the aorta 116. The left aortic sinus contains the origin of the left coronary artery 112(A) (also referred to as "LCA 112(A)"), and the right aortic sinus similarly originates from the right coronary artery 112(B) (also referred to as "RCA 112(B)"). The posterior aortic sinus does not give rise to a coronary artery.

[0034] 2 illustrates various features associated with the coronary arteries 112. As discussed above, the left coronary artery 112(A) and the right coronary artery 112(B) originate from the aortic sinus. The left coronary artery 112(A) originates above the left cusp 208(A) (also referred to as the "left cusp 208(A)") of the aortic valve 208, and the right coronary artery 112(B) originates above the right cusp 208(B) (also referred to as the "right cusp 208(B)") of the aortic valve 208. The root of the aorta 116 includes coronary ostia 210 that connect to the coronary arteries 112, with the left coronary ostia 210(A) located above the left cusp 208(A) and the right coronary ostia 210(B) located above the right cusp 208(B).

[0035] Exemplary aortic valve calcification and prosthetic valve 3 and 4 show cross-sectional views of heart 100 having mineral formations on an aortic valve 208, according to one or more embodiments. As used herein, the terms "mineral formations" or "mineral deposits" may generally refer to one or more minerals embedded in and / or attached to anatomical features. For example, in FIGS. 3 and 4, calcium and / or phosphate are embedded in and / or attached to aortic valve 208, such as on or within the leaflets of aortic valve 208. While many exemplary embodiments are discussed in the context of calcium and / or phosphate formation on the aortic valve, other types of mineral formations may occur on the aortic valve and / or other valves / anatomical features.

[0036] In the examples of FIGS. 3 and 4 , the aortic valve 208 includes relatively severe calcification (e.g., aortic stenosis), necessitating replacement of the aortic valve 208 with a prosthetic valve 402 (shown in FIG. 4 ). In some embodiments, the prosthetic valve 402 may be implanted into the aortic valve 208 by performing a minimally invasive procedure. For example, a physician may make a relatively small incision (e.g., below a threshold size) in the patient, such as in the patient's leg or chest, to access the patient's anatomical lumen, such as an artery or vein. The physician may advance a catheter-based device into the anatomical lumen (e.g., the femoral vein / artery, the inferior vena cava, etc.) and navigate the catheter-based device to the implantation site, i.e., the aortic valve 208. Using the catheter-based device or another device (e.g., a balloon catheter), the physician may deploy the prosthetic valve 402 in the aortic valve 208 to replace the native aortic valve 208. In some embodiments, such procedures include transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) procedures using transcatheter access. Although some embodiments are discussed in the context of implanting a prosthetic valve using transcatheter access, the prosthetic valve may be implanted using other procedures, such as more invasive procedures involving cutting into the heart (e.g., to implant a surgical prosthetic valve).

[0037] In any event, when the prosthetic valve 402 is implanted, the leaflets of the aortic valve 208 may be displaced toward the aortic wall, as shown in FIG. 4 . For example, the prosthetic valve 402 may expand radially, pushing the leaflets of the aortic valve 208 toward the aortic wall. In other words, the size / diameter of the prosthetic valve 402 may be varied to provide an outward radial force, displacing the leaflets of the aortic valve 208 toward the aortic wall. Once implanted, the prosthetic valve 402 may continue to provide an outward radial force, maintaining the leaflets of the aortic valve 208 in the position shown in FIG. 4 . In some cases, with the native leaflets of the aortic valve 208 displaced toward the aortic wall, the native leaflets may limit access to the coronary arteries (not shown in FIGS. 3 and 4 ). That is, the native leaflets may obstruct access from the aorta 116 to the coronary arteries 112 via the coronary ostia 210.

[0038] The prosthetic valve 402 (sometimes referred to as a "prosthetic heart valve 402") can include various types of prosthetic valves, such as a catheter-based prosthetic valve (e.g., a transcatheter heart valve (THV)), a surgical prosthetic valve, etc. In some embodiments, the prosthetic valve 402 is configured to be radially compressed into a compressed state for delivery through a patient's vasculature. The prosthetic valve 402 can be configured to self-expand to a native, uncompressed, or functional state having a preset diameter once placed at a desired location within the patient's vasculature.

[0039] In some embodiments, the prosthetic valve 402 can include a support frame, which may include a lattice framework, such as a stent, configured to secure the prosthetic valve 402 within or adjacent to a defective annulus of the heart 100. The support stent structure can further provide stability and prevent the prosthetic valve 402 from migrating after it is implanted. The support stent structure can include any suitable or desirable material, such as a memory metal, a metal alloy such as stainless steel or cobalt chromium, and / or a polymer. Additionally, the support stent structure can have a configuration other than that shown in FIG. 4. For example, the support stent structure can have a different shape, more or fewer vertical support bars, and / or additional structure for additional stability. In some embodiments, the support stent structure can include a strut mesh and / or a sleeve structure.

[0040] In some embodiments, the supporting stent structure can be secured to a leaflet assembly. The leaflet assembly can include multiple leaflets that collectively function as a one-way valve by coapting. For example, with respect to a prosthetic aortic valve, the leaflet assembly can include three leaflets. However, it will be appreciated that a prosthetic valve can have a greater or lesser number of leaflets. The various components of the leaflet assembly can be formed, in whole or in part, from any suitable biomaterial or polymer, such as, for example, polyethylene terephthalate (PET), ultra-high molecular weight polyethylene (UHMWPE), polytetrafluoroethylene (PTFE), etc.

[0041] Exemplary Architecture 5 illustrates an exemplary architecture 500 for determining access to anatomical features based on analysis of one or more images representing mineral deposits, according to one or more embodiments. The architecture 500 includes one or more imaging devices 502 (referred to as “imaging devices 502” for ease of discussion) configured to capture / generate one or more images of a patient 504 and one or more computing systems 506 (referred to as “computing systems 506” for ease of discussion) configured to evaluate the one or more images to determine access to anatomical features associated with the patient 504. The imaging devices 502 and computing systems 506 may be configured to communicate over one or more networks 508, such as to send / receive data including one or more images created by the imaging devices 502 and / or any other data. The computing systems 506 may be configured to receive input from and / or provide output to a user, such as a physician, technician, radiologist, etc.

[0042] In some embodiments, the imaging device 502 can be configured to generate one or more pre-treatment images of the patient 504 prior to implantation of the prosthetic valve and provide the one or more pre-treatment images to the computing system 506. The computing system 506 can interface with a physician or operate independently to determine the location / characteristics of one or more mineral formations on the native valve based on the one or more pre-treatment images. Following or during implantation of the prosthetic valve, the imaging device 502 can be configured to generate one or more treatment or post-treatment images of the patient 504 and provide the one or more treatment or post-treatment images to the computing system 506. The computing system 506 can interface with a physician or operate independently to identify the location of one or more mineral formations within the cardiac vessel. Furthermore, the computing system 506 can use the pre-treatment data indicating the location of the one or more mineral formations to determine the location of the native valve within the cardiac vessel, which may generally be a displaced location due to implantation of the prosthetic valve. Furthermore, the computing system 506 can determine the location of the prosthetic valve within the cardiac vessel. Based on the location of the native valve and / or prosthetic valve, the computing system 506 can determine the amount of space available for accessing fluid vessels within the cardiac vasculature, such as the coronary arteries.

[0043] While computing system 506 and imaging device 502 are described in many embodiments as performing both pre-treatment and post-treatment processing, computing system 506 and / or imaging device 502 may be implemented as one or more devices / systems capable of performing pre-treatment and / or post-treatment processing. In some embodiments, a first computing system and / or imaging device may be used to perform pre-treatment processing, while a second computing system and / or imaging device may be used to perform post-treatment processing. Furthermore, in some embodiments, imaging device 502 and computing system 506 are located in the same facility / environment / location, while in other embodiments, imaging device and computing system 506 are located in separate facilities / environments / locations.

[0044] The computing system 506 may be implemented as one or more computing devices such as one or more desktop computers, laptop computers, servers, smartphones, electronic reader devices, mobile handsets, personal digital assistants, portable navigation devices, portable gaming devices, tablet computers, wearable devices (e.g., wristwatches, optical head-mounted displays, etc.), portable media players, televisions, set-top boxes, in-vehicle computer systems, appliances, cameras, security systems, home-based computer systems, projectors, medical monitors, etc. In some embodiments, the one or more computing devices are configured in a cluster, data center, cloud computing environment, or a combination thereof. Furthermore, in some embodiments, the one or more computing devices are implemented as remote computing resources located remotely from the imaging device 502. In other embodiments, the one or more computing devices are implemented as local resources located locally in the environment of the imaging device 502.

[0045] As shown, computing system 506 may include one or more of the following components, devices, modules, and / or units (referred to herein as “components”): control circuitry 510, one or more I / O components 512, one or more network interfaces 514, and / or data storage / memory 516, separately / individually and / or in combination / collectively. While several components of computing system 506 are shown in FIG. 5 , it should be understood that additional components not shown can be included in embodiments according to the present disclosure. Furthermore, in some embodiments, some of the illustrated components may be omitted. While control circuitry 510 is shown as a separate component in the diagram of FIG. 5 , it should be understood that any or all of the remaining components of computing system 506 can be embodied, at least in part, in control circuitry 510. That is, the control circuitry 510 may include various devices (active and / or passive), semiconductor materials and / or areas, layers, regions, and / or portions thereof, conductors, leads, vias, connections, etc., and one or more of the other components of the computing system 506 and / or portions thereof may be at least partially formed and / or embodied in / by such circuit components / devices.

[0046] The various components of computing system 506 may be electrically and / or communicatively coupled using certain connection circuits / devices / functionality that may or may not be part of control circuitry 510. For example, the connection functionality may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuits of computing system 506. In some embodiments, two or more of control circuitry 510, one or more I / O components 512, one or more network interfaces 514, and / or data storage / memory 516 may be electrically and / or communicatively coupled to one another.

[0047] The one or more I / O components 512 may include various components for receiving input and / or providing output, such as for interfacing with a user. The one or more I / O components 512 may be configured to receive touch, speech, gestures, or any other type of input. Additionally, the one or more I / O components 512 may be configured to output display data, audio data, haptic feedback data, or any other type of output data. The one or more I / O components 512 may include one or more displays (sometimes referred to as “one or more display devices”), touchscreens, touchpads, controllers, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual or augmented reality devices (e.g., head-mounted displays), speakers (e.g., configured to output sound based on an audio signal), microphones (e.g., configured to receive sound and generate an audio signal), cameras, etc. The one or more displays may include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type of technology. In some embodiments, the one or more displays include one or more touchscreens configured to receive input and / or display data.

[0048] The one or more network interfaces 514 may be configured to communicate with one or more devices / systems over one or more networks 508. For example, the one or more network interfaces 514 may transmit / receive data wirelessly and / or wired over the network, such as one or more images captured by the imaging device 502. The one or more networks 508 may include one or more local area networks (LANs), wide area networks (WANs) (e.g., the Internet), personal area networks (PANs), body area networks (BANs), etc. In some embodiments, the one or more network interfaces 514 may implement wireless technologies such as Bluetooth, Wi-Fi, near field communications (NFC), etc.

[0049] As shown, memory 516 may include a characterization component 518, a graphical user interface component 520, and / or an image processing component 522 configured to facilitate various functions described herein. In some embodiments, one or more of components 518-522 may include and / or be implemented as one or more executable instructions that, when executed by control circuitry 510, cause control circuitry 510 to perform one or more operations. While many embodiments are described in the context of components 518-522 including one or more instructions executable by control circuitry 512, any of components 518-522 may be implemented at least in part as one or more hardware logic components, such as one or more application specific integrated circuits (ASICs), one or more field programmable gate arrays (FPGAs), one or more advanced standard programs packages (ASSPs), one or more complex programmable logic devices (CPLDs), etc. Additionally, although components 518-522 are shown as being included within computing system 506, any of components 518-522 may be implemented at least partially within another device / system, such as imaging device 502 and / or another device / system. Similarly, any of the other components of computing system 506 may be implemented at least partially within another device / system.

[0050] The characterization component 518 can be configured to identify one or more anatomical features and / or properties / locations of one or more anatomical features. For example, the characterization component 518 can evaluate one or more pre-treatment images captured by the imaging device 502 and / or stored in the image data store 524. The one or more pre-treatment images can represent one or more features of the patient 504 before a medical device is implanted in the patient 504, such as before a prosthetic valve is implanted in a cardiac vessel. Evaluation of the one or more pre-treatment images can determine one or more properties / locations of one or more anatomical features within the patient 504. For example, the feature determination component 518 can determine characteristics / locations of the native valve leaflets (e.g., location of the native valve leaflets within the cardiac vessel, length of the leaflets, distance from the edge of the leaflets to a particular plane, location of the edge of the native valve leaflets based on the coapted leaflets, etc.), characteristics / locations of mineral deposits (e.g., location of mineral deposits on the native valve leaflets, dimensions of the mineral deposits, etc.), characteristics / locations of anatomical structures surrounding the native valve leaflets (e.g., diameter of the coronary arteries, diameter of the aorta, distance of the coronary artery ostia from the annular plane and base, etc.), characteristics / locations of the coapted valve leaflets (e.g., location of the coapted valve leaflets), etc. The feature determination component 518 can store data indicative of such characteristics / locations in the anatomical feature data store 526 (sometimes referred to as “pre-treatment data”).

[0051] Additionally, the characterization component 518 can evaluate one or more treatment or post-treatment images captured by the imaging device 502 and / or stored in the image data store 524. The one or more treatment or post-treatment images can represent one or more characteristics of the patient 504 while the medical device is implanted in the patient 504 and / or after the medical device is implanted, such as after a prosthetic valve is implanted in a cardiac vessel. Evaluation of the one or more treatment or post-treatment images can determine one or more properties / locations of one or more anatomical features within the patient 504 during / after the treatment. For example, the characterization component 518 can determine one or more properties / locations related to the aortic annular / valve region, such as properties / locations of the native valve leaflets during / after the treatment, properties / locations of mineral deposits on the native valve leaflets during / after the treatment, properties / locations of anatomical structures surrounding the native valve leaflets during / after the treatment, amount of access to the anatomical features (e.g., amount of access to the coronary arteries) during / after the treatment, etc. The feature determination component 518 can store data indicative of such characteristics / locations in the anatomical feature data store 526 (sometimes referred to as "treatment data" or "post-treatment data").

[0052] In evaluating one or more treatment or post-treatment images, the characterization component 518 can reference data stored in the anatomical feature data store 526, such as pre-treatment data. For example, the characterization component 518 can identify calcium representations in the post-treatment image and determine that the calcium representations correspond to specific calcium deposits on the native valve leaflets based on the pre-treatment data indicating characteristics of the specific calcium deposits (e.g., dimensions of the calcium deposits). Furthermore, the characterization component 518 can also determine the location of the native valve leaflets within the cardiac vessel based on the pre-treatment data, which can indicate the location of the calcium deposits on the native valve leaflets, such as the distance from the edge of the native valve leaflets to the calcium deposits. Furthermore, the characterization component 518 can determine the amount of access to the fluid vessels located proximate to the native valve leaflets (e.g., determine how much the position of the native valve leaflets blocks access to the fluid vessels). For example, it can determine whether there is sufficient space around the native valve leaflets (which may currently be partially covering the coronary artery ostia) for a medical device to access the coronary arteries from the aorta.

[0053] In some embodiments, the feature determination component 518 can evaluate one or more pre-treatment, treatment, and / or post-treatment images to identify visible / represented anatomical features in one or more images, such as walls, calcium deposits, coapted leaflets, cavities, and / or other visible / represented anatomical features. Based on the identification of such visible / represented anatomical features, the feature determination component 518 can determine the properties / locations of the visible / represented anatomical features. Furthermore, the feature determination component 518 can identify hidden / unrepresented anatomical features and / or the properties / locations of hidden / unrepresented anatomical features based on the properties / locations of the visible / represented anatomical features. The feature determination component 518 can store the properties / locations of the represented and / or unrepresented anatomical features in the anatomical feature data store 526.

[0054] In some embodiments, the characterization component 518 can evaluate multiple pre-treatment, treatment, and / or post-treatment images from different orientations / positions / angles. For example, the characterization component 518 can identify one or more characteristics / locations of an anatomical feature by analyzing a first image from a first orientation / position within the patient and a second image from a second orientation / position within the patient.

[0055] Exemplary characteristics / locations of one or more anatomical features may include characteristics / locations of native valve leaflets (e.g., thickness / length / width / shape of the native leaflets, location of the native leaflets within the cardiac vessel, distance from the edge of the native leaflet to a particular plane, location of the edge of the native leaflet based on the coapted leaflets, etc.), characteristics / locations of mineral formations (e.g., thickness / length / width / shape of the mineral formations, location of the mineral formations on the native valve leaflets, location of the mineral formations within the cardiac vessel, etc.), characteristics / locations of fluid vessels (e.g., diameter of the coronary arteries, diameter of the aorta / aortic root, etc.), characteristics / locations of orifices (e.g., location of the coronary ostia within the aortic annulus region and / or relative to the native valve leaflets / prosthetic valve, etc.), and / or any other characteristics / dimensions. In some embodiments, the location of an anatomical feature is represented / illustrated in terms of a dimension, such as distance to another anatomical feature, distance to a prosthetic valve, distance to a mineral formation, etc. Additionally, in some embodiments, the location of an anatomical feature may include one or more coordinates of the anatomical feature within a coordinate system / space.

[0056] In some embodiments, the one or more characteristics / locations of the anatomical feature may include one or more characteristics / locations of a device implanted in the anatomical feature, such as the size / shape / location of a prosthetic valve implanted in the anatomical feature. Further, in some embodiments, the one or more characteristics / locations of the anatomical feature may include one or more characteristics / locations of a mineral formation attached to and / or embedded in the anatomical feature. Further, in some embodiments, the one or more characteristics / locations of the anatomical feature may include a characteristic / location of a visual representation of the anatomical feature within the image, such as the size of the visual representation, the color / shade of the visual representation, the location of the visual representation within the image, etc.

[0057] In some embodiments, the feature determination component 518 operates in cooperation with the graphical user interface component 520. For example, the graphical user interface component 520 can be configured to provide an interface including an image. A user, such as a physician or technician, can view the image and provide input regarding characteristics of anatomical features. In one example, the user can designate a representation in the image as representing a particular anatomical feature, such as a calcium deposit, a valve cusp, a coronary artery, or an aortic wall. In another example, the user can designate a first point / location on the image and a second point / location in the image and provide input requesting that a distance between the first point / location and the second point / location be calculated. The user can also provide input to label the distance. In an example, the user can provide input to determine / label any of the exemplary dimensions discussed in FIGS. 6 and 7. In an example, the feature determination component 518 can use the input provided by the user to evaluate one or more images and / or store data regarding one or more characteristics / locations of one or more anatomical features in an anatomical feature data store at 526.

[0058] Additionally, in some embodiments, the feature determination component 518 operates in cooperation with the image processing component 522 to evaluate the images. For example, the image processing component 522 can perform one or more image processing techniques using one or more images to automatically identify image-based features in the one or more images and / or classify the one or more image-based features as anatomical features. In some embodiments, the image processing component 522 analyzes the one or more images using one or more artificial intelligence techniques, such as one or more machine-trained models. In an example, the feature determination component 518 can use information determined by the image processing component 522 to evaluate the one or more images and / or store data regarding the properties / locations of one or more anatomical features in an anatomical feature data store at 526.

[0059] In some embodiments, one or more of components 518-522 evaluate one or more images to identify anatomical features that may not generally be visible / represented in one or more images. For example, a native valve leaflet may not be visible / represented in a cardiovascular image due to characteristics of the native valve leaflet (e.g., size / dimensions of the native valve leaflet), characteristics of the imaging device 502 (e.g., detectable resolution of the imaging device 502), etc. By way of example, the imaging device 502 may be configured to detect anatomical features larger than a certain size / thickness, and the native valve leaflet may be smaller than that certain size / thickness. In some embodiments, the native valve leaflet may not be detected due to its proximity to a prosthetic valve, which may have a larger size than the native leaflet, and / or other characteristics that would cause the imaging device 502 to detect a stronger signal from the prosthetic valve. That is, the signal from the prosthetic valve may be stronger than the signal from the native valve leaflet, preventing the native valve leaflet from being detected.

[0060] In some embodiments, a single leaflet may not be visible / represented in the image, but the coapted leaflet may be visible / represented in the image. The location / characteristics of the coapted leaflet can be used to determine the tip / edge of the native leaflet. For example, one or more of components 518-522 can evaluate the image to identify the coapted leaflet and determine the characteristics / location of the coapted leaflet and / or other anatomical features within the cardiovascular system, such as the distance from mineral deposits to the tip of the native leaflet (i.e., the coapted leaflet).

[0061] The data / information generated / determined herein can be used in various ways. In some embodiments, data regarding the characteristics / locations of anatomical features can be used to determine whether a procedure, such as a re-access procedure, can be performed. For example, the computing system 506 can generate data indicating the amount of access to the coronary arteries after implanting a prosthetic valve in the aortic valve. Such data can be used to determine whether a medical device, such as a catheter, can access the coronary arteries from the aorta. In an example, it can be determined that there is sufficient space to access the coronary arteries using a medical device if the amount of available space is two to three times larger than the diameter of the medical device. In an example, access to the coronary arteries can be performed above / around / through the prosthetic valve, such as through the frame of the prosthetic valve, and / or above / around the native valve leaflets. In an example, data regarding the amount of access to anatomical features, such as the coronary arteries, can be provided to a user, such as a physician, technician, or patient, to assist the user in making decisions regarding the likelihood of success in performing a procedure after implantation of a prosthetic valve and / or in selecting an appropriate patient for the procedure. In an example, such information can be displayed to the user via a user interface.

[0062] Further, in some embodiments, data regarding the characteristics / locations of anatomical features can be used to generate instructions / information for performing a procedure, such as information indicating where / how a medical device should access the coronary arteries from the aorta. This procedure may be performed by a physician and / or a robotic system (e.g., a robotically controlled procedure). Furthermore, in some embodiments, data regarding the characteristics / locations of anatomical features can be used during a procedure, such as after a procedure to initially implant a prosthetic valve and / or to reposition a prosthetic valve. Such data can assist in placing or repositioning a prosthetic valve in an appropriate position to minimize blockage to the coronary arteries and / or other anatomical features. Additionally, in some embodiments, data regarding the characteristics / locations of anatomical features can be used to implant additional prosthetic valves within an implanted prosthetic valve (sometimes referred to as a "TAVI-in-TAVI procedure"). Furthermore, in some embodiments, data regarding the characteristics / locations of anatomical features can be collected from multiple patients and used to determine metrics for multiple patients, such as the average position of the native valve leaflets, the average amount of space available for accessing the fluid vessels, etc. In an example, such metrics can be provided to a user to assist in making decisions regarding the performance of the procedure.

[0063] As described above, the image data store 524 can store one or more images, such as pre-treatment, treatment, and / or post-treatment images. The image data store 524 can store images from the imaging device 502 and / or other imaging devices. Similarly, the anatomical feature data store 526 can store data regarding the characteristics / locations of pre-treatment, treatment, and / or post-treatment anatomical features. The anatomical feature data store 526 can store data determined / generated by the feature determination component 518, the graphical user interface component 520, the image processing component 522, and / or another device / system. While the image data store 524 and the anatomical feature data store 526 are shown as being included within the computing system 506, in some embodiments, the image data store 524 and / or the anatomical feature data store 526 can be implemented elsewhere, such as in a remote resource.

[0064] The imaging device 502 may be implemented as one or more computed tomography (CT) or computed axial tomography (CAT) devices, magnetic resonance imaging (MRI) devices, X-ray devices, ultrasound devices, infrared thermography (IRT) devices, positron emission tomography (PET) devices, and / or other types of medical imaging devices. The imaging device 502 may generally be configured to capture / generate one or more images including visual representations of the patient's internal anatomical structures, such as organs, tissues, and other anatomical features. In some embodiments, the imaging device 502 captures / generates one or more images from different orientations / angles of the patient 504. This allows the patient's anatomical structures to be viewed at different slices of data and / or from different orientations. The imaging device 502 may be configured to generate two-dimensional (2D) images, three-dimensional (3D) images, models, etc. In some embodiments, contrast agents or other substances are used to assist in the capture / generation of the images. For example, the patient may be required to ingest a substance containing a contrast agent to assist the imaging device 502 in capturing / producing an image.

[0065] As shown, the imaging device 502 may include one or more of the following components, devices, modules, and / or units (referred to herein as “components”) separately / individually and / or in combination / collectively: a control circuit 528, one or more network interfaces 530, a data storage / memory 532, one or more I / O components 534, and one or more imaging components 536. While several components of the imaging device 502 are shown in FIG. 5 , it should be understood that additional components not shown can be included in embodiments according to the present disclosure. Furthermore, in some embodiments, some of the illustrated components may be omitted. While the control circuit 528 is shown as a separate component in the diagram of FIG. 5 , it should be understood that any or all of the remaining components of the imaging device 502 can be embodied, at least in part, in the control circuit 528. That is, the control circuitry 528 may include various devices (active and / or passive), semiconductor materials and / or areas, layers, regions, and / or portions thereof, conductors, leads, vias, connections, etc., and one or more of the other components of the imaging device 502 and / or portions thereof may be at least partially formed and / or embodied in / by such circuit components / devices.

[0066] The various components of the imaging device 502 may be electrically and / or communicatively coupled using a number of connecting circuits / devices / functionality, which may or may not be part of the control circuitry 528. For example, the connecting functionality may include one or more printed circuit boards configured to facilitate the mounting and / or interconnection of at least some of the various components / circuits of the imaging device 502. In some embodiments, two or more of the control circuitry 528, the one or more network interfaces 530, the data storage / memory 532, the one or more I / O components 534, and / or the one or more imaging components 536 may be electrically and / or communicatively coupled to one another.

[0067] The one or more network interfaces 530 may be configured to communicate with one or more devices / systems over one or more networks 508. For example, the one or more network interfaces 530 may transmit / receive data wirelessly and / or wired over the network, such as one or more images. In some embodiments, the one or more network interfaces 530 may implement wireless technologies such as Bluetooth, Wi-Fi, near field communication (NFC), etc.

[0068] The one or more I / O components 534 may include various components for receiving input and / or providing output, such as for interfacing with a user. The one or more I / O components 534 may be configured to receive touch, speech, gestures, or any other type of input. Additionally, the one or more I / O components 534 may be configured to output display data, audio data, haptic feedback data, or any other type of output data. The one or more I / O components 534 may include one or more displays (sometimes referred to as “one or more display devices”), touchscreens, touchpads, controllers, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual or augmented reality devices (e.g., head-mounted displays), speakers (e.g., configured to output sound based on an audio signal), microphones (e.g., configured to receive sound and generate an audio signal), cameras, etc. The one or more displays may include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type of technology. In some embodiments, the one or more displays include one or more touchscreens configured to receive input and / or display data.

[0069] The one or more imaging components 536 may include generators, sensors, detectors, cameras, etc. configured to provide / generate and / or receive / detect signals / radiation and may be used to capture / generate one or more images. In some embodiments, the imaging device 502 may include structure for holding the patient 504 and / or moving the patient 504 into proximity of the one or more imaging components 536.

[0070] The term “control circuitry” is used herein according to its broad and ordinary meaning and can refer to any collection of one or more processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connection circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, graphics processing units, field programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any devices that manipulate signals (analog and / or digital) based on hard-coding of circuit and / or operational instructions. The control circuitry can further include one or more storage devices, which can be embodied within a single memory device, multiple memory devices, and / or embedded circuits of the device. Such data storage can include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information. It should be noted that in embodiments in which the control circuitry includes a hardware state machine (and / or implements a software state machine), the analog, digital, and / or logic circuits, and any associated data storage devices / registers that store the operational instructions may be embedded within or external to the circuitry that includes the state machine, analog, digital, and / or logic circuits.

[0071] The term "memory" is used herein according to its broad and ordinary meaning and can refer to any suitable or desirable type of computer-readable medium. For example, a computer-readable medium can include one or more volatile, non-volatile, removable, and / or non-removable data storage devices implemented using any technology, layout, and / or data structure / protocol that contains any suitable or desirable computer-readable instructions, data structures, program modules, or other types of data.

[0072] Computer-readable media that can be implemented in accordance with embodiments of the present disclosure include, but are not limited to, phase-change memory, static random access memory (SRAM), dynamic random access memory (DRAM), other types of random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technology, compact disc read-only memory (CD-ROM), digital versatile disc (DVD) or other optical storage, magnetic cassette, magnetic tape, magnetic disk storage or other magnetic storage device, or any other non-transitory medium that can be used to store information for access by a computing device. As used in some contexts herein, computer-readable media may generally not include communication media such as modulated data signals and carrier waves. Accordingly, computer-readable media should be understood to generally refer to non-transitory media.

[0073] Exemplary Cardiovascular 6 and 7 illustrate cross-sectional views of exemplary anatomical features and anatomical feature characteristics / locations, according to one or more embodiments. In particular, FIGS. 6 and 7 illustrate anatomical features associated with an aorta 602, i.e., the aortic valve annulus / valve region, including a native valve leaflet 604 attached to an aortic valve annulus 606 at its end 608 and a coronary artery 610 fluidly connected to the aorta 602 via a coronary ostium 612. As shown, the native valve leaflet 604 includes calcium deposits 614 embedded in and / or attached to the native valve leaflet 604. In these examples, the coronary artery 610 is the left coronary artery, which in some cases may be at a higher risk of occlusion during prosthetic valve implantation compared to the right coronary artery. However, it should be understood that the discussion regarding the left coronary artery 610 is equally applicable to the right coronary artery (not shown), another type of fluid vessel, and / or any other anatomical feature. FIG. 6 shows the native valve leaflets 604 in a pre-treatment state without a prosthetic valve 702 implanted in the aortic valve, and FIG. 7 shows the native valve leaflets 604 in a post-treatment state with a prosthetic valve 702 implanted in the aortic valve.

[0074] In some embodiments, the techniques and systems discussed herein can evaluate one or more pre-treatment images representing the anatomical features shown in FIG. 6 to identify visible / represented anatomical features in the one or more pre-treatment images, such as the aortic wall, calcium deposits 614, valve leaflet tips / edges (e.g., based on coapted leaflets), coronary arteries 610, and / or other visible / represented anatomical features. In some examples of evaluating one or more pre-treatment images, native leaflet tips / edges can be identified when a leaflet coapts with another leaflet, such as during closure / diastole. Based on identifying visible / represented anatomical features in the one or more pre-treatment images, the techniques and systems can determine the characteristics / locations of the visible / represented anatomical features (and / or hidden / unrepresented anatomical features), the positioning being expressed in one or more dimensions.

[0075] FIG. 6 illustrates several exemplary dimensions (which may represent / identify the location of anatomical features) that may be determined for one or more pre-treatment images, including the distance / dimension A between the plane 618 of the annulus and the plane 620 of the coronary ostium 612 (also referred to as the “inferior plane 620”), the distance / dimension B between the plane 622 of native leaflet coaptation and the plane 624 of native commissure, the diameter / dimension C of the coronary artery 610 (which may represent the diameter of the left coronary artery 610 proximal to its ostium 612), the distance / dimension D between the upper end of the calcium deposit 614 and the bottom surface 620 of the coronary ostium 612, the distance / dimension E between the upper end 616 of the calcium deposit 614 and the end 616 of the leaflet 604, the distance / dimension F between the plane 618 of the annulus and the plane 622 of native leaflet coaptation, and / or the distance / dimension G between the upper end of the calcium deposit 614 and the plane 618 of the annulus.

[0076] 6, if the upper end of the calcium deposit 614 is located below the plane 620 of the coronary artery ostium 612 during diastole, the distance D may be associated with an identifier indicating such (e.g., a positive sign (+)). Furthermore, if the upper end of the calcium deposit 614 is located above the plane 620 of the coronary artery ostium 612 during diastole, the distance D may be associated with an identifier indicating such (e.g., a negative sign (-)).

[0077] 7 illustrates the example aortic valve of FIG. 6 with a prosthetic valve 702 implanted. In particular, the prosthetic valve 702 is expanded to an implanted / deployed state in the aortic valve. As shown, the native valve leaflets 604 are repositioned to a substantially straight and vertical position. Here, the native valve leaflets 604 and / or the prosthetic valve 702 at least partially block the coronary ostium 612.

[0078] 7 to identify visible / represented anatomical features in the one or more images, e.g., the aortic wall, calcium deposits 614, coronary arteries 610, prosthetic valves 710, and / or other visible / represented anatomical features. Based on identifying visible / represented anatomical features in the one or more images, the techniques and systems can determine the characteristics / locations of the visible / represented anatomical features (and / or hidden / non-represented anatomical features), where the location is expressed in one or more dimensions.

[0079] FIG. 7 shows several example dimensions (which may represent / identify the location of anatomical features) that may be determined for one or more treatment / post-treatment images, including the distance / dimension H between the plane 620 of the coronary artery ostium 612 and the upper end of the calcium deposit 614 (e.g., the plane 704 of the upper end of the calcium deposit 614), the distance / dimension I between the frame of the prosthetic valve 702 and the center of the coronary artery ostium 612, the distance / dimension J between the plane 704 of the upper end of the calcium deposit 614 and the sinotubular junction (STJ) plane 706, and / or the distance / dimension K between the plane 704 of the upper end of the calcium deposit 614 and the upper end 708 of the prosthetic valve 702.

[0080] In some embodiments, if the upper end of the calcium deposit 614 is located below the plane 620 of the coronary ostium 612 after deployment of the prosthetic valve 702, the distance H may be associated with an identifier indicating such (e.g., a positive sign (+)). Furthermore, if the upper end of the calcium deposit 614 is located above the plane 620 of the coronary ostium 612 after deployment of the prosthetic valve 702, as shown in FIG. 7, the distance H may be associated with an identifier indicating such (e.g., a negative sign (-)). Furthermore, in some embodiments, once the prosthetic valve 702 is implanted, the position of the upper end / tip of the native valve leaflet 604 approaches the position of the center of the coronary ostium 612.

[0081] 6 and / or 7 , the techniques and systems discussed herein can determine one or more additional dimensions to represent / identify anatomical features with the implanted prosthetic valve 702, including, for example, the distance / dimension KH between the upper end 708 of the prosthetic valve 702 and the plane 620 of the coronary ostium 612 (i.e., distance K plus distance H), the distance / dimension JK between the STJ plane 706 and the upper end 708 of the prosthetic valve 702 (i.e., distance J minus distance K), the distance / dimension JE between the STJ plane 706 and the upper end / tip 616 of the native valve 604 (i.e., distance J minus distance E), the distance / dimension KE between the upper end 708 of the prosthetic valve 702 and the upper end 616 of the native valve leaflet 604 (i.e., distance K minus distance E), and / or the distance / dimension EH between the upper end 616 of the native valve leaflet 604 and the plane 620 of the coronary ostium 612 (i.e., distance E plus distance H).

[0082] In some embodiments, the techniques and systems discussed herein can use one or more of the dimensions discussed above to determine the amount of access to the coronary arteries 620. For example, the distances KH, KE, and / or JE can indicate the amount of space available to access the coronary arteries 610 over / through the prosthetic valve 702 and / or over the native valve leaflets 604. In other words, the distances KH, KE, and / or JE can indicate how much the prosthetic valve 702 and / or the native valve leaflets 604 obstruct the coronary ostia 612 to the coronary arteries 610. Such information can be useful in determining whether implantation of the prosthetic valve 702 allows for access through the coronary arteries 610 to perform a procedure. When the prosthetic valve 702 is implanted in the aortic valve (as shown in FIG. 7 ), the amount of access to the coronary arteries 610 is reduced compared to an aortic valve without a prosthetic valve (as shown in FIG. 6 ). Although distances KH, KE, and / or JE are discussed in the examples, one or more other dimensions may be used in determining the amount of space available for accessing the coronary artery 610.

[0083] 6 and 7, other dimensions may additionally or alternatively be determined. In some embodiments, the techniques and systems discussed herein may use one or more algorithms to determine the distance / dimension associated with an anatomical feature, for example, an algorithm that converts the number of pixels in an image or the distance between pixels to the distance / dimension of the anatomical feature.

[0084] Exemplary Flow Diagram 8A, 8B, and 9 show example flow diagrams of processes for performing one or more techniques described herein. The various blocks associated with the processes may be performed by one or more devices / systems, users, etc. For example, one or more of the blocks may be performed by control circuitry of the computing system 506 and / or the imaging device 502, and / or may be performed by a physician, technician, and / or any other user.

[0085] 8A-8B show an example flow diagram of a process 804 for analyzing one or more images to determine the location / characteristics of anatomical features, according to one or more embodiments. In FIG. 8A, at block 802, process 800 may include acquiring one or more first images representing a native valve in a cardiac vessel. In some embodiments, control circuitry of the device / system may receive one or more pre-treatment images from an imaging device. The one or more pre-treatment images may include data representing a cardiac vessel, such as an aortic valve in the aortic annulus region. Additionally, in some embodiments, a user may acquire / receive one or more pre-treatment images from an imaging device, a computing system, and / or another device / system.

[0086] At block 804, process 800 may include analyzing the one or more first images to determine one or more characteristics / locations of one or more mineral formations. In examples, the characteristics of the mineral formations may include the size / shape / dimensions of the mineral formations. Further, in examples, the location of the mineral formations may include the location of the mineral formations relative to anatomical features such as the tip / end or another portion of a native valve leaflet, a coronary artery, an aortic wall, a coordinate system / space, etc.

[0087] In some embodiments, as shown in block 806, the control circuitry can perform one or more image processing techniques using the one or more pre-treatment images to determine one or more characteristics / locations of one or more mineral formations. For example, the one or more image processing techniques can include detection, which attempts to identify one or more image features (e.g., edges, corners, blobs, ridges, etc.) within the image; tracking, which attempts to track one or more image features across images / frames; and / or classification, which attempts to classify one or more image features into one or more categories. In examples, the one or more image processing techniques can use one or more models, such as a machine-trained model, a user-trained model, or another model trained to classify image features (e.g., image features indicative of mineral formations). In some embodiments, the control circuitry can determine any of the dimensions described with reference to FIGS. 6 and 7.

[0088] Further, in some embodiments, as shown in block 806, the control circuitry can provide a user interface to a user and / or receive input regarding one or more characteristics / locations of one or more mineral formations. For example, the control circuitry can generate user interface data representing a user interface including a pre-treatment image and / or transmit user interface data to a display device for display of a user interface including the pre-treatment image. The user can view the pre-treatment image through the interface and provide input identifying the location of the mineral formation. In one example, the user can designate a representation / location within the image as representing a mineral formation. In another example, the user can designate a first point / location on the image and a second point / location on the image and provide input requesting that the distance between the first point / location and the second point / location be calculated. The first point / location and / or the second point / location can be on or near the mineral representation. Thus, the distance can indicate the location of the mineral formation relative to another feature. In some embodiments, the user can select various points / locations on the image to designate (and / or have the control circuitry determine) any of the dimensions described with reference to FIGS. 6 and 7 .

[0089] In some embodiments, the control circuitry and / or user can identify the tips / edges of the native valve leaflets based on coapted leaflets (i.e., leaflets that are touching or in close proximity to each other). For example, the control circuitry and / or user can identify an area in the image associated with a particular shade / color / size typically associated with coapted leaflets. The control circuitry and / or user can designate the area of ​​the coapted leaflets as the tips / edges of the native valve leaflets. In an example, the control circuitry and / or user can determine the location of the mineral formation relative to the tips / edges of the native valve leaflets, such as the distance between the location of the mineral formation and the tips / edges of the native valve leaflets.

[0090] At block 810, process 800 may include generating pre-treatment data indicative of one or more characteristics / locations of one or more mineral formations. In some embodiments, the control circuitry may generate pre-treatment data indicative of one or more characteristics / locations of the one or more mineral formations based on the characteristics / locations determined / identified at block 804. Once generated, the pre-treatment data may be stored in a data store, such as a data store associated with the control circuitry and / or located on a network.

[0091] At block 812, process 800 may include acquiring one or more second images representing the prosthetic valve implanted in the native valve. In some embodiments, the control circuitry may receive one or more treatment / post-treatment images from the imaging device. The one or more treatment / post-treatment images may include data representing a prosthetic valve in a cardiovascular system, such as a prosthetic aortic valve deployed in an aortic valve. Additionally, in some embodiments, a user may acquire / receive one or more treatment / post-treatment images from the imaging device, a computing system, and / or another device / system.

[0092] At block 814, process 800 may include obtaining pre-treatment data. In some embodiments, the control circuitry may retrieve the pre-treatment data from a data store, which in some cases may be located on a network. In an example, the pre-treatment data may indicate one or more characteristics / locations of one or more mineral formations prior to implantation of the prosthetic valve. Additionally, in some embodiments, a user may obtain / receive the pre-treatment data.

[0093] In FIG. 8B, at block 816, process 800 may include analyzing one or more second images to determine one or more characteristics / locations of one or more mineral formations and / or one or more characteristics / locations of the prosthetic valve.

[0094] In some embodiments, as indicated at block 818, the control circuitry may perform one or more image processing techniques using the one or more treatment / post-treatment images to determine one or more characteristics / locations of one or more mineral formations, which may include one or more of the techniques described above with reference to block 806. In an example, the control circuitry may obtain pre-treatment data indicative of characteristics of the mineral formations / pre-treatment mineral representations, such as the size / shape / color of the mineral formations and / or the size / shape / color of the visual representations representing the mineral formations in the pre-treatment images. The control circuitry may use the pre-treatment data to identify mineral representations in the treatment / post-treatment images that have one or more similar characteristics (e.g., satisfying one or more similarity thresholds) as the mineral formations / mineral representations in the pre-treatment images.

[0095] Additionally, in some embodiments, the control circuitry can perform one or more image processing techniques using one or more treatment / post-treatment images to determine one or more characteristics / locations of the prosthetic valve. For example, the control circuitry can identify one or more representations in the post-treatment image as corresponding to one or more elements of the prosthetic valve if the one or more representations are arranged along a substantially perpendicular plane / axis, are connected to each other via one or more connected representations, have characteristics of a typical prosthetic valve, etc. In an example, the control circuitry can reference a library of prosthetic valve data to identify characteristics of the prosthetic valve, such as a typical frame size / shape or another characteristic of the prosthetic valve.

[0096] Further, in some embodiments, as also shown in block 818, the control circuitry can provide a user interface to a user and / or receive input regarding one or more mineral formations and / or one or more characteristics / locations of the prosthetic valve. For example, the control circuitry can generate user interface data representing a user interface including the treatment / post-treatment images and / or transmit the user interface data to a display device for display of the user interface. The user can view the treatment / post-treatment images via the interface and can provide input identifying the location of the mineral formations and / or the location of the prosthetic valve, similar to one or more of the techniques described above with reference to block 806. In an example, the user interface can display information regarding the pre-treatment images and / or the mineral formations within the pre-treatment images to assist the user in identifying the mineral formations in the treatment / post-treatment images.

[0097] At block 820, process 800 may include determining a position of the native valve within the cardiac vessel. In some embodiments, the control circuitry and / or user may determine the position of the native valve / leaflets within the cardiac vessel based on the location of mineral formations on the native valve leaflets before implantation of the prosthetic valve (which may be indicated in the pre-procedure data) and / or the location of mineral formations within the cardiac vessel after implantation of the prosthetic valve. In an example, the position / orientation of the native valve leaflets may be estimated based on the location of one or more mineral formations and / or the location of the prosthetic frame. For example, if multiple mineral formations and / or frame elements of the prosthetic valve are identified in a substantially vertical plane / axis, the native valve leaflets may be estimated to be substantially parallel to and / or within a distance to the vertical plane / axis.

[0098] At block 822, process 800 may include determining access to a fluid vessel associated with a cardiac vessel. For example, the control circuitry and / or user may determine an amount of access to a fluid vessel associated with a cardiac vessel based on the location of the native valve within the cardiac vessel after implantation of the prosthetic valve, the location of the prosthetic valve within the cardiac vessel, etc. The amount of access may indicate available space above the native valve leaflets and / or prosthetic valve, and / or through a portion of the prosthetic valve above the native valve leaflets. In some embodiments, the control circuitry may determine one or more of the dimensions shown in FIG. 6 and / or FIG. 7 and use the one or more dimensions to determine the amount of available space, such as between the tip / end of the native valve leaflet and the portion of the aortic wall substantially above the tip / end of the native valve leaflet, between the top end of the prosthetic valve and the portion of the aortic wall substantially above the end of the prosthetic valve, etc.

[0099] Additionally, in some embodiments, the control circuitry can provide treatment / post-treatment images to a user interface, and a user can provide input to select the top of the mineral formation and select a portion of the aortic wall. The user can provide input requesting calculation of the distance between the top of the mineral formation and the portion of the aortic wall. The control circuitry can determine such distance and use that distance, as well as any other distances, to determine the amount of access space.

[0100] At block 824, process 800 may include generating data indicative of one or more characteristics / positions of the native valve and / or prosthetic valve. For example, the control circuitry may generate data indicative of one or more characteristics / positions of the native valve / valve leaflets and / or prosthetic valve after implantation of the prosthetic valve within a cardiac vessel. In some embodiments, the data may also indicate the amount of access to a fluid vessel, such as a dimension indicative of the amount of access to a fluid vessel. The control circuitry may store the data in a data store.

[0101] At block 826, process 800 may include providing an indication indicating the access status of a fluid vessel, such as a coronary access status. In some examples, an indication may be provided indicating the risk / risk level associated with performing a procedure that includes accessing a fluid vessel (e.g., high / medium / low risk of a blockage to the coronary artery due to implantation of a prosthetic valve and / or the position of the native valve leaflets). For example, the indication may indicate that access to the coronary artery is completely blocked, partially blocked, open (e.g., not blocked), etc. The indication may be based on and / or indicate the amount of access to the fluid vessel. In some embodiments, the indication is provided to the user via a display or other output device, such as a visual / audio representation. However, the indication may be provided in other ways. In some embodiments, the patient may be associated with the indication indicating the access status of the fluid vessel.

[0102] At block 828, process 800 may include performing a procedure involving accessing a fluid vessel or refraining from performing a procedure. In some embodiments, process 800 may include determining that the amount of access to a coronary artery is below a threshold and / or that the risk / risk level is a particular value (e.g., a relatively high risk of a blockage to the coronary artery), and, based on such a determination, refraining from performing a procedure involving accessing a coronary artery. Alternatively or additionally, process 800 may include determining that the amount of access to a coronary artery is above a threshold and / or that the risk / risk level is a particular value (e.g., a relatively low risk of a blockage to the coronary artery), and, based on such a determination, performing a procedure involving accessing a coronary artery.

[0103] One or more of blocks 802-828 can be performed at various times. In some embodiments, one or more of blocks 802-810 can be performed before the prosthetic valve is implanted, and one or more of blocks 812-828 can be performed after the prosthetic valve is implanted. Additionally, in some embodiments, one or more of blocks 802-810 can be performed after the prosthetic valve is implanted. For example, one or more pre-procedure images taken before the prosthetic valve is implanted can be analyzed after the prosthetic valve is implanted. However, blocks 802-828 can be performed at other times and / or in any order.

[0104] 9 shows an example flow diagram of a process 900 for providing an interface for determining the location / characteristics of an anatomical feature, according to one or more embodiments. At block 902, the process 900 may include receiving data indicative of the location / characteristics of mineral formations. For example, the control circuitry may retrieve pre-treatment data from a data store. In some embodiments, the pre-treatment data may indicate one or more characteristics / locations of one or more mineral formations prior to implantation of the prosthetic valve, for example, the location of the mineral formations relative to the ends / tips of the native valve leaflets.

[0105] At block 904, the process 900 may include generating graphical interface data representing an image of the prosthetic valve implanted on the native valve. For example, the control circuitry may generate user interface data representing a user interface including treatment / post-treatment images of the prosthetic valve implanted on the native valve.

[0106] At block 906, process 900 may include providing graphical interface data to a display device. For example, the control circuitry may transmit the graphical interface data to the display device to display a user interface including treatment / post-treatment images. In some embodiments, the display device is a component of a computing system in which the control circuitry is located, while in other embodiments, the display device is a component of another computing system.

[0107] At block 908, process 900 may include receiving input regarding the location / characteristics of the mineral representations within the images. For example, the control circuitry may receive input via a user interface regarding the location / characteristics of the mineral representations shown in the treatment / post-treatment images, such as input identifying the location of the mineral formations, dimensions associated with the mineral formations, etc.

[0108] At block 910, process 900 may include performing one or more image processing techniques using the images. For example, the control circuitry may perform one or more image processing techniques using the treatment / post-treatment images to determine that mineral representations in the images represent mineral formation on native valve leaflets. In an example, the one or more image processing techniques may use data indicative of one or more characteristics of the mineral formation.

[0109] At block 912, process 900 may include determining the location of the native valve and / or prosthetic valve within the cardiac vessel. For example, the control circuitry may determine the location of the native valve / valve leaflets within the cardiac vessel based on the input received at block 908, the image processing performed at block 910, and / or pre-treatment data indicative of the location / characteristics of mineral formations.

[0110] At block 914, the process 900 may include determining access to a fluid vessel associated with the cardiac vessel. For example, the control circuitry may determine the amount of access to the coronary artery based on the location of the native valve / valve leaflets and / or the location of at least a portion of the prosthetic valve within the cardiac vessel.

[0111] Example images 10 and 11 illustrate exemplary pre-treatment images 1000 and post-treatment images 1100, respectively, that may be generated by an imaging device according to one or more embodiments. In these examples, images 1000 and 1100 represent CT or X-ray images illustrating various anatomical features within the aortic valve region. For example, images 1000 and 1100 illustrate an aortic valve 1002 located between a left ventricle 1004 and an aorta 1006, and a coronary artery 1008 located above the aortic valve 1002. FIG. 10 illustrates the aortic valve region in a pre-treatment state without a prosthetic valve 1102, while FIG. 11 illustrates the aortic valve region with a prosthetic valve 1102 implanted to replace the aortic valve 1002. While the native leaflets of the aortic valve 1002 may generally not be visualized / represented in a CT or X-ray image, for ease of illustration, the native leaflets of the aortic valve 1002 are illustrated in FIGS. 10 and 11 with dotted lines.

[0112] In these examples, the aortic valve 102 includes calcium deposits 1010, which may appear as white representations (e.g., lighter areas) in the images 1000 and 1100. The calcium deposits 1010 may include specific characteristics / locations that may enable the calcium deposits 1010 to be detected by the imaging device. For example, the calcium deposits 1010 may each have a size that meets a size / thickness threshold associated with detection by the imaging device. While the calcium deposits 1010 are shown in these examples as attached to the apex of the native leaflets of the aortic valve 1002, the calcium deposits 1010 may be attached / embedded beneath and / or within the native leaflets.

[0113] As shown in FIG. 10 , the pre-treatment image 1000 also includes a slightly darker region 1012 indicative of the coapted leaflets. The coapted leaflets may include certain characteristics / locations that can enable the coapted leaflets to be detected by the imaging device. For example, the coapted leaflets may include two or more native leaflets that may be touching or proximate each other, creating a substantially thicker region than the native leaflets alone, so the coapted leaflets may meet a size / thickness threshold associated with detection by the imaging device. The region 1012 may generally represent the ends / tips of the native leaflets of the aortic valve 1002. Thus, while the native leaflets of the aortic valve 1002 may generally not be visible / represented in the pre-treatment image 1000, the tips / edges of the native leaflets of the aortic valve 1000 may be visible / represented (e.g., by the darker region 1012) when the native leaflets are coapted with another leaflet.

[0114] In some embodiments, the systems and techniques discussed herein can analyze the pre-treatment image 1000 of FIG. 10 to identify visible / represented features and / or determine one or more characteristics / locations of visible / represented and / or hidden / unrepresented features within the pre-treatment image 1000. For example, the systems and techniques can identify calcium deposits 1010, regions 1012 representing the tips / edges of the native leaflets of the aortic valve 1002, the aortic wall, coronary arteries 1008, and / or other anatomical features. The systems and techniques can also determine characteristics related to such features, such as the location of the feature, the size / shape of the feature, etc. In some embodiments, the systems and techniques can use the location of the calcium deposits 1010 to estimate the location of the native leaflets of the aortic valve 1002. For example, the location of the native leaflets of the aortic valve 1002 can be estimated to be below / above / below the calcium deposits 1010. Data regarding the characteristics / location of calcium deposits 1010 and / or the estimated characteristics / location of the native leaflets of the aortic valve 1002 (and / or other information) may be stored as pre-treatment data.

[0115] As described above, FIG. 11 shows a post-procedure image 1100 illustrating an aortic valve region having a prosthetic valve 1102 implanted to replace the aortic valve 1002. Here, the native leaflets of the aortic valve 1002 are pushed toward the aortic wall and coronary arteries 1008 by an outward radial force exerted by the prosthetic valve 1002. Because the frame of the prosthetic valve 1102 can generally have a size / thickness that meets a size / thickness threshold associated with detection by the imaging device, the frame of the prosthetic valve 1102 can be detected by the imaging device and represented in the post-procedure image 1100. As shown in FIG. 11 , the frame of the prosthetic valve 1102 is shown in white (e.g., representing multiple frame elements / portions).

[0116] 11 to identify visible / represented features and / or determine one or more characteristics / locations of visible / represented and / or hidden / unrepresented features in the post-treatment image 1100. For example, the systems and techniques can identify calcium deposits 1010, the aortic wall, the coronary arteries 1008, frame elements of the prosthetic valve 1102, and / or other anatomical features. The systems and techniques can also determine characteristics related to such features, such as feature location, feature size / shape, etc. In some embodiments, the systems and techniques can use the location of the calcium deposits 1010 in the pre-treatment image 1000 to estimate the location of the native leaflets of the aortic valve 1002 and / or access to the coronary arteries 1008 (e.g., amount of access to the coronary arteries 1008). Data regarding the characteristics / location of the calcium deposits 1010 and / or the estimated characteristics / location of the native leaflets of the aortic valve 1002 and / or the estimated access (and / or other information) can be stored as post-procedure data. In some embodiments, the systems and techniques discussed herein can map the likelihood of sinus isolation.

[0117] Additional Features and Embodiments The above description of embodiments of the present disclosure is not intended to be exhaustive or to limit the disclosure to the precise form disclosed above. While specific embodiments and examples have been described above for illustrative purposes, various equivalent modifications are possible within the scope of the present disclosure, as those skilled in the art will recognize. For example, while processes or blocks are presented in a given order, alternative embodiments may perform routines having steps or use systems having blocks in a different order, and some processes or blocks may be deleted, moved, added, subdivided, combined, and / or modified. Each of these processes or blocks may be implemented in a variety of different ways. Also, while processes or blocks are at times shown as being performed in serial, these processes or blocks may instead be performed in parallel or at different times.

[0118] Several terms of position are used herein with respect to various disclosed embodiments. While several spatially relative terms, such as "outer," "inner," "superior," "lower," "upper," "vertical," "horizontal," "top," "bottom," and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure, it should be understood that these terms are used herein for ease of description to describe the positional relationships between elements / structures as shown in the drawings. The spatially relative terms are intended to encompass different orientations of the elements / structures during use or operation in addition to the orientation shown in the drawings. For example, an element / structure described as "above" another element / structure can represent a position that is below or to the side of such other element / structure, and vice versa, with respect to the intended patient or alternative orientations of the element / structure.

[0119] Conditional language used herein, e.g., "can," "could," "might," "may," "for example," and the like, unless otherwise indicated or understood as used within the context, is intended to have its ordinary meaning and is intended to convey that, generally, some embodiments include certain features, elements, and / or steps, while other embodiments do not. Thus, such conditional language is not intended to imply that features, elements, and / or steps are generally required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining, with or without author input or prompting, whether these features, elements, and / or steps are included in or should be performed in any particular embodiment.

[0120] It should be understood that some ordering terms (e.g., “first” or “second”) may be provided for ease of reference and do not necessarily imply physical characteristics or order. Thus, as used herein, ordering terms (e.g., “first,” “second,” “third,” etc.) used to modify elements such as structures, components, operations, etc., do not necessarily indicate a priority or order of the element with respect to any other elements, but rather generally distinguish the element from another element having a similar or identical name (provided the ordering term is used). Additionally, as used herein, the indefinite articles (“a” and “an”) can indicate “one or more” rather than “one.” Furthermore, an action performed “based on” a condition or event may also be performed based on one or more other conditions or events not explicitly listed. In some contexts, a description of an action or event occurring or being performed “based on” or “based at least in part on” a stated event or condition can be interpreted as being triggered by or being performed in response to the stated event or condition.

[0121] Although a particular order of operations or steps is illustrated and / or described with respect to the various methods and processes disclosed herein, it should be understood that the various steps and operations illustrated and described may be performed in any suitable or desirable temporal order. Further, any of the illustrated and / or described operations or steps may be omitted from any given method or process, and the illustrated / described methods and processes may include additional operations or steps not explicitly illustrated or described.

[0122] In the above description of the embodiments, it should be appreciated that various features may be grouped together in a single embodiment, figure, or description thereof to streamline the disclosure and aid in understanding one or more of the various aspects of the disclosure. However, this method of disclosure should not be interpreted as reflecting an intention that any claim requires more features than are expressly recited in that claim. Moreover, any component, feature, or step illustrated and / or described in a particular embodiment herein may be applied to or used in conjunction with any other embodiment. Furthermore, no component, feature, step, or group of components, features, or steps is necessary or essential to each embodiment. Therefore, it is intended that the scope of the present disclosure should not be limited by the specific embodiments described above, but should be determined solely by a fair reading of the claims that follow.

[0123] Unless the context clearly requires otherwise, throughout the specification and claims, the words "comprise," "comprising," "have," "having," "include," "including," and the like are intended to be interpreted in an open, inclusive sense, i.e., "including but not limited to," as opposed to a closed, exclusive, or exhaustive sense.

[0124] The term "coupled," as used generally herein, refers to two or more elements that can be physically, mechanically, and / or electrically connected or otherwise associated, whether directly or indirectly (e.g., through one or more intermediate elements, components, and / or devices). Additionally, as used herein, the terms "herein," "above," "below," and terms of similar import shall refer to this application as a whole, including any disclosure incorporated by reference, and not to any particular portions of this disclosure. Where the context allows, terms in this disclosure using the singular or plural number can also include the plural or singular number, respectively.

[0125] The word "or," in reference to a list of two or more items, includes all of the following interpretations of that word: any of the items in the list, all of the items in the list, and any combination of the items in the list. Additionally, as used herein, the term "and / or" used between elements (e.g., between the last two of a list of elements) means any one or more of the referenced / associated elements. For example, the phrase "A, B, and / or C" means "A," "B," "C," "A and B," "A and C," "B and C," or "A, B, and C."

[0126] The terms "substantially" and "about" may be used herein to provide an industry-accepted tolerance for the corresponding term and / or relativity between items. In some industries, the industry-accepted tolerance may be less than 1 percent, while in other industries, the industry-accepted tolerance may be 10 percent or greater. Other examples of industry-accepted tolerances range from less than 1 percent to 50 percent. Industry-accepted tolerances may correspond to, but are not limited to, component values, integrated circuit process variations, temperature variations, rise and fall times, thermal noise, dimensions, signaling errors, dropped packets, temperature, pressure, material composition, and / or performance metrics. Within an industry, the tolerances for accepted tolerances may be greater or less than the percentage level (e.g., a dimensional tolerance of less than about + / - 1%). Some relativities between items may range from differences less than the percentage level to several percent. Other relativities between items may range from differences of several percent to the magnitude of the difference.

[0127] One or more embodiments have been described above using method steps that illustrate the performance of certain functions and their relationships. The boundaries and sequences of these functional building blocks and method steps have been arbitrarily defined herein for convenience of description. Alternative boundaries and sequences may be defined so long as the specified functions and relationships are properly performed. Accordingly, any such alternative boundaries or sequences are within the scope and spirit of the claims. Furthermore, the boundaries of these functional building blocks have been arbitrarily defined herein for convenience of description. Alternative boundaries may be defined so long as some key functions are properly performed. Similarly, flow diagram blocks have also been arbitrarily defined herein to illustrate certain key functions.

[0128] To the extent used, flow diagram block boundaries and sequences could have been defined otherwise and still perform certain significant functions. Accordingly, such alternative definitions of both functional units, flow diagram blocks, and sequences are within the scope and spirit of the claims. Those skilled in the art will also recognize that the functional units and other example blocks, modules, and components herein can be implemented as shown, or by discrete components, application-specific integrated circuits, processors executing appropriate software, etc., or any combination thereof.

[0129] One or more embodiments are used herein to illustrate one or more aspects, one or more features, one or more concepts, and / or one or more examples. Physical embodiments of an apparatus, article of manufacture, machine, and / or process may include one or more of the aspects, features, concepts, examples, etc. described with reference to one or more of the embodiments discussed herein. Furthermore, between figures, embodiments may incorporate the same or similarly named functions, steps, modules, etc., which may use the same, related, or unrelated reference numbers. Related features, elements, functions, operations, modules, etc. may be of the same or similar functionality, or may be unrelated. [Explanation of symbols]

[0130] 100 Heart 102 Left ventricle 104 Left atrium 106 Right ventricle 108 Right atrium 110 Bottom end 112 Coronary Arteries 114 Base 116 Ascending aorta 118 Inferior vena cava 120 Superior vena cava 202 Mitral valve 204 Tricuspid valve 206 Pulmonary valve 208 Aortic Valve 402 Artificial valves 500 Architecture 502 Imaging device 504 patients 506 Computing Systems 508 Network 510 Control circuit 512 I / O Components 514 network interface 516 Data Storage / Memory 518 Characterization Component 520 Graphical User Interface Components 522 Image Processing Component 524 Image Data Store 526 Anatomical Features Datastore 528 Control Circuit 530 network interface 532 Data Storage / Memory 534 I / O Components 536 Imaging Components 602 Aorta 604 Natural leaflet 606 Aortic valve annulus 608 End 610 Coronary Arteries 612 Coronary Ostium 614 Calcium deposits 616 Upper end 618 plane 620 plane 622 plane 624 Natural commissural plane 702 Artificial valves 704 plane 706 plane 708 Top 1000 pre-treatment images 1002 Aortic valve 1004 Left ventricle 1006 Aorta 1008 Coronary Artery 1010 Calcium deposits 1012 area 1100 Post-treatment images 1102 Artificial valves

Claims

1. 1. A method for determining the position of a native valve leaflet, comprising: acquiring a pre-treatment image representing a native valve within a cardiac vessel; analyzing the pre-treatment images to determine the location of mineral deposits on the native leaflets of the native valve; acquiring, by a control circuit, a post-procedure image representative of a prosthetic valve implanted onto the native valve; analyzing the post-treatment images to identify the location of the mineral deposits within the cardiac vessel; determining, by the control circuitry, a position of the native valve leaflet within the cardiac vessel based at least in part on the position of the mineral deposits on the native valve leaflet and the position of the mineral deposits within the cardiac vessel; A method comprising:

2. 10. The method of claim 1, wherein the native valve comprises the aortic valve and the cardiovascular vessel comprises the aorta.

3. determining access to a fluid vessel associated with the cardiac vessel based at least in part on the position of the native valve leaflet within the cardiac vessel; 3. The method of claim 1 or 2, further comprising:

4. identifying a location of at least a portion of the prosthetic valve within the cardiac vessel based at least in part on the analysis of the post-procedure images. and wherein the step of determining access to the fluid vessel is based at least in part on the location of at least the portion of the prosthetic valve within the cardiac vessel. The method of claim 3.

5. identifying a location of coapted valve leaflets within the cardiac vessel based at least in part on the analysis of the pre-treatment images; determining an edge of the native valve leaflet based at least in part on the position of the coapted leaflets; determining the distance between the edge of the native valve leaflet and the mineral deposit; and wherein the step of determining access to the fluid vessel is based at least in part on the distance between the edge of the native valve leaflet and the mineral deposit. The method of claim 3.

6. analyzing the pre-treatment images to identify the location of the mineral deposits on the native valve leaflets; generating user interface data representative of the pre-treatment image; providing the user interface data to a display device; receiving input regarding the mineral deposits; identifying the location of the mineral deposit based at least in part on the input; 6. The method of any one of claims 1 to 5, comprising:

7. analyzing the pre-treatment images to identify the location of the mineral deposits on the native valve leaflets; performing one or more image processing techniques using the pre-treatment images to identify the location of the mineral deposits on the native valve leaflets.

7. The method of any one of claims 1 to 6, comprising:

8. a control circuit; communicatively coupled to the control circuit and, when executed by the control circuit, causing the control circuit to receiving data indicative of a location of mineral formations on native leaflets of a native valve in a cardiac vessel; generating graphical interface data representing an image of the prosthetic valve implanted in the native valve; receiving input regarding a location of a mineral representation within the image; determining a location of the native valve leaflets within the cardiac vessel based at least in part on the input and the data; and a memory storing executable instructions for performing operations including A computing system comprising:

9. The computing system of claim 8 , wherein the image comprises at least one of a computed tomography image or an X-ray image of the cardiovascular vessel.

10. 10. The computing system of claim 8 or 9, wherein the native valve comprises the aortic valve and the cardiovascular system comprises the aorta.

11. The operation is determining an amount of coronary access based at least in part on the location of the native valve leaflets within the cardiac vessel; 11. The computing system of claim 8, further comprising:

12. The operation is Identifying the location of at least a portion of the prosthetic valve within the aorta.

12. The computing system of claim 11, further comprising: wherein said determining said amount of access to said coronary artery is based at least in part on said location of at least said portion of said prosthetic valve within said aorta.

13. 13. The computing system of claim 8, wherein the data indicates a position of the mineral formation relative to an end of the native valve leaflet, and wherein determining the position of the native valve leaflet within the cardiac vessel is based at least in part on the position of the mineral formation relative to the end of the native valve leaflet.

14. the data being indicative of one or more characteristics of the mineral formation, and the operation being: performing one or more image processing techniques using the image to determine, based at least in part on the data, that the mineral representation in the image represents the mineral formation on the native valve leaflet.

14. The computing system of claim 8, further comprising:

15. 1. A method comprising: acquiring, by a control circuit, an image representative of the prosthetic valve implanted on the native valve within the cardiovascular system; receiving, by the control circuitry, data indicative of a location of mineral formation on the native valve leaflets prior to implantation of the prosthetic valve; analyzing the images to identify the location of the mineral formation within the cardiac vessel; determining a location of the native valve leaflet within the cardiac vessel based at least in part on the location of the mineral representation and the data; A method comprising:

16. determining an amount of access to a fluid vessel associated with the cardiac vessel based at least in part on the position of the native valve leaflet within the cardiac vessel; 16. The method of claim 15, further comprising:

17. Identifying the location of at least a portion of the prosthetic valve within the cardiac vessel. and wherein the determining the amount of access to the fluid vessel is based at least in part on the location of at least the portion of the prosthetic valve within the cardiac vessel.

17. The method of claim 16.

18. identifying the location of coapted valve leaflets within the cardiac vessel; determining an edge of the native valve leaflet based at least in part on the position of the coapted leaflets; determining the distance between the edge of the native valve leaflet and the mineral formation; and wherein determining the amount of access to the fluid vessel is based at least in part on the distance between the edge of the native valve leaflet and the mineral formation.

17. The method of claim 16.

19. 19. The method of claim 15, wherein the data indicates a position of the mineral formation relative to an end of the native valve leaflet, and wherein determining the position of the native valve leaflet within the cardiovascular vessel is based at least in part on the position of the mineral formation relative to the end of the native valve leaflet.

20. analyzing the image to identify the location of the mineral formation within the cardiac vessel; performing one or more image processing techniques using the image to identify the location of the mineral formation within the cardiac vessel.

20. The method of any one of claims 15 to 19, comprising:

21. 1. A method comprising: analyzing a first image to determine the location of mineral deposits on a native valve leaflet within a cardiac vessel, the first image representing a prosthetic valve; analyzing a second image to identify the location of the mineral deposit within the cardiac vessel, the second image representing a prosthetic valve; determining coronary access based at least in part on the location of the mineral deposits on the native valve leaflets and the location of the mineral deposits within the cardiac vessel; providing an indication indicative of coronary artery access status, the indication being based at least in part on the determined access to the coronary artery; A method comprising:

22. 22. The method of claim 21, wherein the indication indicates a risk level associated with performing a procedure that involves accessing the coronary artery.

23. the indication indicates an amount of access to the coronary artery, and the method comprises: determining that the amount of access to the coronary artery is less than a threshold; refraining from performing a procedure involving accessing the coronary artery based at least in part on determining that the amount of access to the coronary artery is less than the threshold; and 23. The method of claim 21 or 22, further comprising:

24. the indication indicates an amount of access to the coronary artery, and the method comprises: determining that the amount of access to the coronary artery is greater than a threshold; performing a procedure that includes accessing the coronary artery based at least in part on determining that the amount of access to the coronary artery is greater than the threshold; and 23. The method of claim 21 or 22, further comprising:

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