CTFR 18/477,440 CTFR 100770 DETAILED ACTION Notice of Pre-AIA or AIA Status 07-03-aia AIA 15-10-aia The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA. Response to Amendment Applicant has made amendments to the claims. The claims have been considered and examined accordingly. Claim Objections 07-29-01 AIA Claim s 5-6 and 8-9 objected to because of the following informalities: (claim 5) “… the first line…” should be “… a first line…” (typo) (claim 6) “… the third line…” should be “… a third line” (typo) (claim 8) “… the third line… the first line… the second line” should be “… a third line… a first line… a second line” (typo) (claim 9) “… the third line… the first line” should be “ a third line… a first line” (typo) Appropriate correction is required. Claim Rejections - 35 USC § 102 07-06 AIA 15-10-15 In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status. 07-07-aia AIA 07-07 The following is a quotation of the appropriate paragraphs of 35 U.S.C. 102 that form the basis for the rejections under this section made in this Office action: A person shall be entitled to a patent unless – 07-08-aia AIA (a)(1) the claimed invention was patented, described in a printed publication, or in public use, on sale, or otherwise available to the public before the effective filing date of the claimed invention. 07-12-aia AIA (a)(2) the claimed invention was described in a patent issued under section 151, or in an application for patent published or deemed published under section 122(b), in which the patent or application, as the case may be, names another inventor and was effectively filed before the effective filing date of the claimed invention. 07-15 AIA Claim s 1 and 3 are rejected under 35 U.S.C. 102( a)(1 ) as being anticipated by Wang (US 12527635 B2) . With respect to claim 1 , Wang teaches a method, comprising: obtaining an image dataset of a patient acquired by an imaging system (“a method for planning a medical procedure using a graphical user interface may include displaying image data via the graphical user interface and receiving a first user input defining a target of the medical procedure within the displayed image data. The method may further include displaying an interactive image via the graphical user interface, the interactive image comprising the image data, a plurality of connected anatomical passageways detected by segmentation of the image data, and the defined target.” Page 46 col 1 lines 56-65) ; displaying an image of the image dataset within a graphical user interface (GUI) on a display device communicatively coupled to the imaging system (“a method for planning a medical procedure using a graphical user interface may include displaying image data via the graphical user interface and receiving a first user input defining a target of the medical procedure within the displayed image data. The method may further include displaying an interactive image via the graphical user interface, the interactive image comprising the image data, a plurality of connected anatomical passageways detected by segmentation of the image data, and the defined target.” Page 46 col 1 lines 56-65 and figure 1) , wherein the image of the image dataset is a two-dimensional (2D) image (see figures 5A-5F) ; determining a first anatomical landmark point of the image (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16 ; determining a second anatomical landmark point of the image (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) ; generating an annotation overlay based at least in part on the first and second anatomical landmark points, wherein the annotation overlay comprises a plurality of straight lines (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) ; displaying the annotation overlay over the image in the GUI (see figures 5A-5F) ; and saving data of the annotation overlay to memory (“FIG. 7 illustrates graphical user interface 400 in a save mode according to some embodiments. The save mode is used when the planned medical procedure is complete and/or ready to transfer to a medical instrument to perform the medical procedure. A set of options 710 are presented via graphical user interface 400. Options 710 may include a transfer option, a discard option, a delete option, and/or a save option. The save option may include saving the plan locally, saving to an external device, and/or transmitting the plan over the network, e.g., to a cloud storage facility. One or more options may require an external storage device to be installed” page 59 col. 27 lines 40-51) . With respect to claim 3 , Wang teaches the method of claim 1, wherein determining the first anatomical landmark point comprises receiving a first user input (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) to the GUI and determining the second anatomical landmark point comprises receiving a second user input to the GUI (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) . Claim Rejections - 35 USC § 103 07-20-aia AIA The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action: A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made. 07-21-aia AIA Claim s 2, 4-9, 11-13, 15-16, and 19-20 are rejected under 35 U.S.C. 103 as being unpatentable over Wang (US 12527635 B2) in view of Russo (Chen C, Okoh A, Garg A, Russo M. Catheter-Based Mitral Intervention imaging and Procedural TEE. November 2020.) . With respect to claim 2 , Wang teaches the method of claim 1, but does not teach wherein the plurality of straight lines of the annotation overlay comprises a first line connecting the first and second anatomical landmark points, a second line perpendicular to the first line, and a third line perpendicular to the second line, wherein the second line connects the first line to the third line and defines a height of the third line above the first line. Russo teaches wherein a plurality of straight lines of the annotation overlay comprises a first line connecting the first and second anatomical landmark points (see figure 13) , a second line perpendicular to the first line (see figure 13) , and a third line perpendicular to the second line (see figure 1)3 , wherein the second line connects the first line to the third line and defines a height of the third line above the first line (see figure 13) . Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 4 , Wang teaches the method of claim 1, and while Wang does teach anatomical landmark points (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) it does not explicitly teach wherein the first anatomical landmark point is a first mitral valve annulus point indicating a first end of a mitral valve annulus and the second anatomical landmark point is a second mitral valve annulus point indicating a second end of the mitral valve annulus. Russo teaches wherein the first anatomical landmark point is a first mitral valve annulus point indicating a first end of a mitral valve annulus (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) and the second anatomical landmark point is a second mitral valve annulus point indicating a second end of the mitral valve annulus (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 5 , Wang and Russo teach the method of claim 4, Russo further teaches wherein the first line connecting the first anatomical landmark point to the second anatomical landmark point approximates a position of the mitral valve annulus (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . With respect to claim 6 , Wang teaches the method of claim 1, but wherein the third line defines a third anatomical landmark point. Russo teaches wherein the third line defines a third anatomical landmark point (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)). Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 7 , Russo and Wang teach the method of claim 6, Russo further teaches wherein the third anatomical landmark point is a position of a transseptal puncture (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . With respect to claim 8 , Wang teach the method of claim 1, but does not teach wherein the height of the third line above the first line is defined by a length of the second line. Russo teaches wherein the height of the third line above the first line is defined by a length of the second line (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 9 , Wang teaches the method of claim 1, and further teaches it comprising determining the height based on user input (“Implementations may include one or more of the following features. The method including providing a line tool via the graphical user interface to receive the second user input. The method where adjusting the interactive image includes: determining a distance represented by the trajectory” page 48 col 5 lines 30-34) , Russo additionally teaches determining the height of the third line above the first line based on a detected tenting position (see Figure 12 and “The position of the BRK transseptal needle (St. Jude Medical, Inc, St Paul, Minnesota, USA) can be seen by a tent-like indentation of the interatrial septum (‘tenting’) (Figure 11) Thereby, the tip of the ‘tent’ points towards the left atrium. With a satisfactory posterior and superior location, the height above the valve is assessed in a four-chamber view (Figure 12).” Page 17 paragraph 1) . Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 11 , Wang teaches a system, comprising: a computing device communicatively coupled to an imaging system configured to generate image data of a patient (see figure 1 element 108); and to a display device (see figure 1 element 110) , the computing device configured with instructions in non-transitory memory (figure 1 element 112) that when executed cause the computing device to: display a two-dimensional (2D) image acquired by the imaging system in a graphical user interface (GUI) on the display device (see figures 5A-5F) ; generate an annotation based on a plurality of landmark points determined within the 2D image (“FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like. In some examples, certain tools may be enabled and/or disabled based on the current view displayed in workspace 522. For example, a tool that is not used by the current view may be hidden, grayed out, and/or otherwise not selectable. In some examples, clicking on a tool may cause a menu to appear with a list of sub-tools. For example, the object drawing tool may include sub-tools for drawing various 2D and/or 3D objects, such as freeform objects, predefined 2D shapes (e.g., circles, rectangles, ellipses, etc.), 3D shapes (e.g., spheres, 3D ellipsoids, etc.), and/or the like. In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col 22 lines 28-45 and “In FIG. 5E, hazard fence 570 is displayed a conic hazard fence with a pair of outer control points 573 and 574 used to define a 3-dimensional circular disk as the base of the cone and a vertex control point 575 used to define the height of a cone. In FIG. 5F, hazard fence 570 is displayed as a hemispherical hazard fence with a triad of control points 576-578 used to define a hemisphere. In FIGS. 5E and 5F, interactive window 541 further includes target 550 and trajectory 560. When trajectory 560 connects to an exit location that is not in the plane of the underlying image (that is, when trajectory 560 projects into and/or out of interactive window 541) a projection 579 is displayed to link trajectory 560 to modeled passageways” Page 58 col 25 lines 3-16) ; display the annotation as an overlay on the 2D image (see figures 5A-5F) ; and save the annotation to memory (“FIG. 7 illustrates graphical user interface 400 in a save mode according to some embodiments. The save mode is used when the planned medical procedure is complete and/or ready to transfer to a medical instrument to perform the medical procedure. A set of options 710 are presented via graphical user interface 400. Options 710 may include a transfer option, a discard option, a delete option, and/or a save option. The save option may include saving the plan locally, saving to an external device, and/or transmitting the plan over the network, e.g., to a cloud storage facility. One or more options may require an external storage device to be installed” page 59 col. 27 lines 40-51) , but does not teach wherein the annotation comprises a first straight line between a first landmark point of the plurality of landmark points and a second landmark point of the plurality of landmark points, a second straight line perpendicular to the first line, and a third straight line perpendicular to the second line and defining a third landmark point, wherein the third landmark point is a height above the first straight line defined by a length of the second straight line, wherein the 2D image is a live intraoperative image and the length of the second straight line is determined based on a tenting position detected within the image. Russo teaches wherein the annotation comprises a first straight line between a first landmark point of the plurality of landmark points and a second landmark point of the plurality of landmark points (see figure 13) , a second straight line perpendicular to the first line (see figure 13) , and a third straight line perpendicular to the second line (see figure 13) and defining a third landmark point, wherein the third landmark point is a height above the first straight line defined by a length of the second straight line (see figure 13) , wherein the 2D image is a live intraoperative image (Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) and the length of the second straight line is determined based on a tenting position detected within the image (see Figure 12 and “The position of the BRK transseptal needle (St. Jude Medical, Inc, St Paul, Minnesota, USA) can be seen by a tent-like indentation of the interatrial septum (‘tenting’) (Figure 11) Thereby, the tip of the ‘tent’ points towards the left atrium. With a satisfactory posterior and superior location, the height above the valve is assessed in a four-chamber view (Figure 12).” Page 17 paragraph 1) . Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 12 , Wang and Russo teach the system of claim 11. Wang further teaches wherein the length of the second straight line is adjustable based on one or more user inputs (“As described herein, visual representations of data points may be rendered to display system 110. For example, measured data points, moved data points, registered data points, and other data points described herein may be displayed on display system 110 in a visual representation. The data points may be visually represented in a user interface by a plurality of points or dots on display system 110 or as a rendered representation (e.g., a rendered model), such as a mesh or wire model created based on the set of data points. In some examples, the data points may be color coded according to the data they represent. In some embodiments, a visual representation may be refreshed in display system 110 after each processing operation has been implemented to alter data points.” Page 52 col. 13 lines 40-53 and “As depicted in in FIGS. 5A-5G, the list of tools includes a move tool, a magnifier tool, a window/level tool, an object drawing tool, a line drawing tool, a trimming tool, a hazard tool, an angle and/or distance measurement tool, an undo/redo tool, and/or the like.” Page 56 col. 22 lines 27-33) . With respect to claim 13 , Wang and Russo teach the system of claim 11. Wang teaches images acquired through an ultrasound imaging system (“The virtual visualization system processes images of the surgical site imaged using imaging technology such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and/or the like.” page 52 col. 14 lines 37-43) and Russo further teaches wherein the imaging system is an ultrasound imaging system configured to acquire echocardiogram images (see figure 13: 4-chamber TEE view from transeptal height (TS)) . With respect to claim 15 , Wang and Russo teach the system of claim 11 Russo further teaches wherein the first landmark point is a first mitral valve annulus point (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) , the second landmark point is a second mitral valve annulus point (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) , and the third landmark point is a transseptal puncture position (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . With respect to claim 16 , Wang teaches a method, comprising: obtaining one or more images acquired by an imaging system (“a method for planning a medical procedure using a graphical user interface may include displaying image data via the graphical user interface and receiving a first user input defining a target of the medical procedure within the displayed image data. The method may further include displaying an interactive image via the graphical user interface, the interactive image comprising the image data, a plurality of connected anatomical passageways detected by segmentation of the image data, and the defined target.” Page 46 col 1 lines 56-65) ; displaying a first image of the one or more images in a graphical user interface (GUI) on a display device (see figures 5A-5F) ; adjusting, in response to a user input to the GUI, the initial length of a second line to an adjusted length without altering first and second points (see figure 5A-5F and interactive window 541) . Wang does not teach determining a first mitral valve annulus point of the first image; determining a second mitral valve annulus point of the first image; generating a transseptal puncture (TSP) annotation based on the first and second mitral valve annulus point and a TSP height, wherein the TSP annotation comprises a first line perpendicular to a second line and parallel to a third line, the first line extending between the first and second mitral valve annulus points and the second line extending between the first line and the third line, wherein the third line extends over an interatrial septum, wherein an initial length of the second line is predefined; displaying the TSP annotation as an overlay on the first image; and Russo teaches determining a first mitral valve annulus point of the first image (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) ; determining a second mitral valve annulus point of the first image (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) ; generating a transseptal puncture (TSP) annotation based on the first and second mitral valve annulus point and a TSP height (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) , wherein the TSP annotation comprises a first line perpendicular to a second line and parallel to a third line (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) , the first line extending between the first and second mitral valve annulus points and the second line extending between the first line and the third line (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) , wherein the third line extends over an interatrial septum, wherein an initial length of the second line is predefined (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) ; displaying the TSP annotation as an overlay on the first image (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) ; Russo is analogous art in the same field of endeavor as the claimed invention. Russo is directed towards GUI based planning of TSP procedures (See Mitra Clip Procedure Step: Access-Venous puncture + Transseptal puncture on page 13) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo by utilizing the marking place locations as disclosed by Russo, with the user input capabilities of Wang with the expectation that doing so would lead to better patient outcomes (see Russo “However, there is a significant learning curve associated with the MitraClip implantation which suggests this therapy should be performed in centers of excellence with recognized surgical and structural expertise in mitral valve pathologies. Patient selection and detailed assessment of mitral valve pathology and mechanism of MR are vital for a successful mitral clip procedure. Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top)) . With respect to claim 19 , Wang and Russo teach the method of claim 16. Russo further teaches wherein the initial length is predefined based on a detected position of a tenting in the interatrial septum (see Figure 12 and “The position of the BRK transseptal needle (St. Jude Medical, Inc, St Paul, Minnesota, USA) can be seen by a tent-like indentation of the interatrial septum (‘tenting’) (Figure 11) Thereby, the tip of the ‘tent’ points towards the left atrium. With a satisfactory posterior and superior location, the height above the valve is assessed in a four-chamber view (Figure 12).” Page 17 paragraph 1) . With respect to claim 20 , Russo and Wang teach the method of claim 16. Russo further teaches wherein the third line has a first length at least as long as a second length of the first line (see figure 13 and “The site of optimal transseptal puncture is slightly different for PMR and FMR. In structural mitral leaflet disease (e. g. prolapse or flail), the puncture site needs to be 4–5 cm above the mitral annulus to guarantee enough space for adequate catheter and MitraClip maneuvering. In contrast, in cases of functional MR, the line of coaptation is usually below the plane of the mitral annulus due to extensive tethering. Therefore, the puncture site in these patients needs to be more inferior and closer to the annular plane (about 3.5-4.5 cm above the annular plane). Also, a different location of a lesion that cause MR may also require adjustment of septal puncture site (Figure 13).” Page 17 (bottom)- page 18 (top)) . 07-22-aia AIA Claim 10 is rejected under 35 U.S.C. 103 as being unpatentable over Wang and Russo as applied to claim 1 above, and further in view of Zhu (US20180325488A1) . With respect to claim 10 , Wang teaches the method of claim 1, but does not teach the method of claim 1, wherein the first and second anatomical landmarks are determined in an automated manner based on machine learning algorithms. Zhu teaches wherein the first and second anatomical landmarks are determined in an automated manner based on machine learning algorithms (“As a method of extracting the landmark geometry, a method based on, for example, a constrained local model (CLM) is used. As described above, the geometric model is, for example, a set of vertexes that constitute a contour of a cardiac muscle of the heart present on a medical image or a set of the landmarks shown in FIG. 4. The CLM is configured with two phases, i.e., construction of the geometric model and extraction thereof. First, in the geometric model construction phase, learning of what part corresponds to each landmark of the heart is carried out. Information about the learned landmark geometry is stored in the storage device 4. In the subsequent geometry extraction phase, landmarks of the heart are searched from within the image using the data learned in the geometric model construction and stored.” Paragraph 0042) . Zhu is analogous art in the same field of endeavor as the claimed invention. Zhu is directed to diagnostic medical imaging of the heart (“The present invention relates to a diagnostic ultrasound technique for extracting standard view information for diagnosis from three-dimensional information and providing the standard view information” paragraph 0001 and fig. 4) . A person of ordinary skill in the art before the effective filing date of the claimed invention, would have found it obvious to combine the system of Wang with the teachings of Zhu, by utilizing Zhu’s teachings of machine learning integrated image analysis inside the image based planning system of Wang, with the expectation that doing so would lead to a more accurate plan due to the machine learning based landmark extraction (“According to the present invention, an ultrasonic imaging device for acquiring a cardiac standard view from three-dimensional information can acquire a robust and high-accuracy standard view from an extracted landmark geometry on the basis of recommendations in a guideline.” Paragraph 0011) . 07-22-aia AIA Claim 14 is rejected under 35 U.S.C. 103 as being unpatentable over Wang and Russo as applied to claim 11 above, and further in view of Geode (US 11500920 B2) . With respect to claim 14 , Wang and Russo teach the system of claim 11, but do not teach any further limitations. Geode teaches wherein the saved annotation (“An annotation may also be stored in a separate file (i.e., apart from, but related to, the image). The text information may or may not be automatically displayed (i.e., may or may not be visually hidden as a default by an image viewer). It is noted that the text information may be accessible for publishing, cataloging, displaying (e.g., interactive display), and annotation drawing. As will be appreciated, storing text information (e.g., metadata and vector-based annotations) inside the image file, may link the text information with the image information.” Page 23 col. 4 lines 52-61) is accessible to be overlaid on one or more images of the patient (“In one specific embodiment, a system may process and aggregate images including annotations (e.g., annotated regions of interest) across image specialties and modalities (e.g., radiology, pathology, surgery and oncology), wherein the annotations (e.g., metadata) may maintain relationships across images one or more images within a data set. Annotated regions of interest (ROI) may maintain a relationship with an original image that may be part of a data set for a given record or case. Annotated ROI may include annotated information to describe a relationship between and across images from a different modality or modality as a group to convey meaning in diagnosis or treatment. The information may be modified (e.g., across clinical imaging modalities) to reflect a change in a record for a given diagnosis and/or treatment plan.” Page 25 cols 7 (lines 59-67) – 8 (lines 1-6)) . Geode is analogous art in the same field of endeavor as the claimed invention. Geode is directed towards “visual annotations on medical images” (page 22 lines 15-16) . A person of ordinary skill in the art before the effective filing date of the claimed invention would have found it obvious to combine the teachings of Wang, Russo, and Geode by utilizing the combined systems annotating methodology with the saving and loading functionality of Geode, with the expectation that doing so would enable the information to be shared amongst different specialists and providers improving patient outcome (“Bringing specialists and providers together to evaluate imaging and diagnostic summaries for a case, in stages, in a timely manner, may improve the treatment outcome of the patient. For example, a pathologist may consult with a surgeon and an oncologist.” Page 25 col 7 lines 36-40) . 07-22-aia AIA Claim s 17-18 are rejected under 35 U.S.C. 103 as being unpatentable over Wang and Russo as applied to claim 16 above, and further in view of Zhu . With respect to claim 17 , Wang and Russo teach the method of claim 16, but do not teach wherein the first and second mitral valve annulus point are determined in an automated manner. Zhu teaches wherein the first and second anatomical landmarks are determined in an automated manner (“As a method of extracting the landmark geometry, a method based on, for example, a constrained local model (CLM) is used. As described above, the geometric model is, for example, a set of vertexes that constitute a contour of a cardiac muscle of the heart present on a medical image or a set of the landmarks shown in FIG. 4. The CLM is configured with two phases, i.e., construction of the geometric model and extraction thereof. First, in the geometric model construction phase, learning of what part corresponds to each landmark of the heart is carried out. Information about the learned landmark geometry is stored in the storage device 4. In the subsequent geometry extraction phase, landmarks of the heart are searched from within the image using the data learned in the geometric model construction and stored.” Paragraph 0042) . It would have been obvious for a person of ordinary skill before the effective filing date of the claimed invention to combine the system of Wang and Russo with Zhu by utilizing the automatic landmark generation capabilities of Zhu with the marking place locations as disclosed by Russo, with the expectation that doing so would extend the capabilities the already included semi-automatic object detection processes of Wang (see Wang “In some examples, tool selector 524 may include tools for semi-automatically detecting objects in the underlying image data (e.g., clicking a point in the image data and using edge detection techniques to automatically identify a corresponding object).” Page 56 col. 22 lines 43-45) . With respect to claim 18 , Wang, Russo, and Zhu teach the method of claim 17. Russo further teaches wherein the one or more images acquired by the imaging system are acquired and displayed in real-time (Providing clear TEE images of mitral structures and MitralClip device components intra-operatively for guidance and monitoring of the device advancement and placement, and cohesive interaction by clear communication between intraoperative TEE imager and device implanter (cardiac surgeon/interventional cardiologist) are an integrated part of successful MitraClip implantation” page 1 (bottom) – page 2 (top) . Response to Arguments Applicant’s arguments filed 02/18/2026 have been fully considered. With respect to pages 7-9 of applicant’s remarks, applicant argues that the rejection for claim 16 should be withdrawn because newly amended claim 16 contains new limitations that provide for “an interactive real-time user manipulation of already generated annotations” (see page 8 (bottom) of applicant’s remarks) . The examiner disagrees. While the amendments made do overcome the previously used Haak, upon further search and consideration the rejection has been updated utilizing new art (See above claim mapping) . Additionally, the BRI for the limitation, now present within amended claim 16, of “adjusting, in response to a user input to the GUI, the initial length of the second line to an adjusted length without altering the first and second mitral valve annulus points” is broader than the applicant’s applied interpretation of an interactive real-time user manipulated annotation. As is currently written the BRI of the limitation applies to any adjustments to the annotation made in response to a user input to the GUI. With respect to pages 9-13 of applicant’s remarks applicant makes many arguments directed towards the previously made 103 rejections. Most of these arguments have been rendered moot due to the rejections being updated with new art. On pages 10-11 applicant argues the newly added limitation, within claims 1 and 11, requiring landmark determinations on a 2D image overcomes Haak. The examiner agrees but after further search and consideration has found prior art and has provided an updated rejection (See above claim mapping). The applicant makes similar arguments against the previous 103 rejection of newly amended claim 11 again these rejections have been largely rendered moot due to the updated rejection (see above claim mapping) . On pages 12-13 the applicant argues again that Haak does not teach the newly added limitations that require a 2D image and determining lines based on tenting. The examiner agrees that as amended claim 11 overcomes Haak, but has provided an updated rejection using new art found after further search and consideration (see above claim mapping) . Finally, on page 13, the applicant argues that due to claim 10 being dependent on claim 1 and because claim 1 now requires a 2D image, that the claim 10 should be rendered allowable over prior art. The examiner agrees that the previous combination did not teach a 2D image however the newly made combination of prior art does (see above claim mapping) . Due to the newly made amendments new prior art was brought in to teach the previously untaught and unseen limitations. Accordingly, all independent claims and their dependents remain rejected as currently presented. Conclusion 07-96 AIA The prior art made of record and not relied upon is considered pertinent to applicant's disclosure : Mentis (US 10169535 B2) – discloses a live surgical annotation method Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL . See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a). A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action. Any inquiry concerning this communication or earlier communications from the examiner should be directed to REBECCA C WILLIAMS whose telephone number is (571)272-7074. The examiner can normally be reached M-F 7:30am - 4:00pm. Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice. If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Andrew W Bee can be reached at (571)270-5183. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300. Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000. /REBECCA COLETTE WILLIAMS/Examiner, Art Unit 2677 /ANDREW W BEE/Supervisory Patent Examiner, Art Unit 2677
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