Transaortic valve access device

Abstract

A valve insertion device for traversing a wire guide through a valve within an intraluminal passage. A wire guide is positioned near the outflow of a valve within an intraluminal passage. Alongside the wire guide, a pressure sensor is positioned to detect the pressure of the fluid in the intraluminal passage. As the valve opens, the fluid pressure at the outflow of the valve increases. This information is sent from the pressure sensor to a control system. From this information, the control system can determine when the valve will open and can actuate an advancement system to move the wire guide to traverse the open valve. After traversing the valve, various catheters and sheaths may be advanced over the wire guide through the valve.

1 .- 20 . (canceled) 
     
     
         21 . A cardiovascular valve insertion device comprising,
 a wire guide having proximal and distal portions;   a pressure sensor positioned near the distal portion of the wire guide, wherein the pressure sensor is configured to detect fluid pressure information of an area within an intraluminal passage near a valve; and   a control system configured to receive the fluid pressure information from the pressure sensor to determine when the valve is open, and display information to enable the distal portion of the wire guide to move through the valve when the valve is open.   
     
     
         22 . The valve insertion device of  claim 21 , wherein the control system comprises display indicating when the wire guide should be advanced to enable the distal portion of the wire guide to move through the valve. 
     
     
         23 . The valve insertion device of  claim 22 , wherein the display is timed to account for a predetermined reaction time by an operator. 
     
     
         24 . The valve insertion device of  claim 22 , wherein the display comprises a first indicator to display when the wire guide should be advanced and a second indicator to display when the distal end of the wire guide has advanced through the valve. 
     
     
         25 . The valve insertion device of  claim 22 , wherein the wire guide comprises a torque sensor configured to send information to the control system indicating when the wire guide has advanced against tissue of the valve. 
     
     
         26 . The valve insertion device of  claim 25 , wherein the display comprises a third indicator to display when the wire guide has advanced against tissue of the valve. 
     
     
         27 . The valve insertion device of  claim 21 , comprising a plurality of pressure sensors, and wherein the control system is configured to determine a lateral position of the wire guide in the intraluminal passage by comparing the information received by each pressure sensor. 
     
     
         28 . The valve insertion device of  claim 27 , wherein the control system comprises display indicating when the wire guide is aligned with the center of the intraluminal passage. 
     
     
         29 . The valve insertion device of  claim 21 , wherein the pressure sensor is contained within a lumen in a catheter and wherein the pressure sensor has a distal end positioned on an opening along an outer surface of a distal end catheter. 
     
     
         30 . The valve insertion device of  claim 21 , wherein the pressure sensor is built into the wire guide. 
     
     
         31 . A method of passing a device through a valve, comprising,
 positioning an elongate medical device having a distal portion within an intraluminal passage near a valve;   positioning a pressure sensor alongside the distal portion of the elongate medical device;   detecting fluid pressure information within the intraluminal passage near the valve after an opening of the valve;   sending fluid pressure information from the pressure sensor to a control system;   predicting by the control system when the valve will be open using the fluid pressure information from a plurality of the openings of the valve; and   advancing the elongate medical device such that the distal end of the elongate medical device moves through the open valve.   
     
     
         32 . The method of  claim 31 , further comprising displaying when the valve will be open to an operator. 
     
     
         33 . The method of  claim 32 , wherein displaying when the valve will be open is timed to accommodate for a reaction time of an operator. 
     
     
         34 . The method of  claim 31 , further comprising displaying when the distal portion of the wire guide has passed through the valve. 
     
     
         35 . The method of  claim 31 , wherein the elongate medical device is positioned on a downstream side of the valve. 
     
     
         36 . The method of  claim 31 , further comprising:
 detecting when the elongate medical device is pressing against tissue by registering a signal in the control system from a torque sensor; and   retracting the elongate medical device by actuating the advancement system.   
     
     
         37 . The method of  claim 31 , further comprising:
 detecting when the elongate medical device is pressing against tissue by registering a signal in the control system from a pressure sensor contained in the distal portion of the elongate medical device; and   retracting the elongate medical device by actuating the advancement system.   
     
     
         38 . The method of  claim 31 , further comprising determining a lateral position of the elongate medical device in the intraluminal passage by comparing the information received by a plurality of pressure sensors, wherein the plurality of pressure sensors have different lateral positions within the intraluminal passage. 
     
     
         39 . The method of  claim 31 , further comprising:
 after the distal end of the elongate medical device has moved through the open valve, retracting the pressure sensor from the intraluminal passage without substantially moving the position of the elongate medical device.   
     
     
         40 . The method of  claim 31 , wherein advancement of the wire guide is hand-manually controlled by an operator.