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This paper presents a 2-D/3-D registration method for the alignment of cardiac X-ray images to ECG gated CTA data of the coronary arteries. The purpose of our work is to provide visualization of instruments in relation to pre-operative CTA data during interventional cardiology for improved image guidance, especially in complex procedures. The method utilizes the graphical processing unit (GPU) for rendering of digitally reconstructed radiographs (DRRs) from a 3-D CTA-derived coronary model. Using a multi-scale gradient ascent framework, the normalized cross correlation between the simulated and real X-ray image is optimized. Quantitative evaluation is performed by computing the projection error of the vessel centerlines, which was on average 1.34 mm.

Objectives: To determine the occurrence of in-hospital complications after transcatheter aortic valve implantation (TAVI) according to the Valve Academic Research Consortium (VARC) criteria in addition to the length of stay (LOS). Background: The absence of uniformity in endpoint definitions challenges the comparison between previously reported major adverse cerebro-and cardiovascular event rates after TAVI. To address this, in 2009, the VARC was established aiming to provide standardized endpoint definitions for TAVI clinical trials. Methods: Between November 2005 and September 2010, we prospectively enrolled 150 consecutive patients who underwent TAVI with the Medtronic CoreValve System in our institution. Complications, prosthetic valve associated endpoints, and therapy-specific endpoints were defined according to the definitions provided by the VARC. Results: The mean age (+/- SD) was 81 (+/- 7) years and 55% were female. Thirty-day or in-hospital mortality was 11%, and the 30-day combined safety endpoint was 22%. Seventy-six patients (51%) had >= 1 cardiovascular and/or noncardiovascular complication of whom 16 also underwent a new permanent pacemaker implantation (PPI). In the 74 patients with uneventful TAVI, 12 patients (8%) underwent PPI. TAVI was truly uneventful in 62 patients (41%). Bleeding complications were observed most frequently (31%), followed by acute kidney injury (18%), vascular complications (16%), and stroke/TIA (11%). The median LOS in patients with a complicated and a truly uncomplicated TAVI was 14.0 (8.0-20.5) and 8.0 (7.0-10.8) days, respectively (P < 0.001). Conclusion: TAVI was associated with >= 1 cardiovascular and/or noncardiovascular event in 51% of the patients; new PPI was needed in another 8%, and TAVI was truly uncomplicated in 41%. Complications and need for new PPI significantly prolonged LOS. (C) 2011 Wiley-Liss, Inc.

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