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Image-guidance for transcatheter aortic valve implantation (TAVI) and cerebral embolic protection
- Source :
- International Journal of Cardiology. 249:90-95
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- The study was aimed at evaluation of the feasibility and potential benefit of image fusion (IF) of pre-procedural CT angiography (CTA) and x-ray (XR) fluoroscopy for image-guided navigation in transfemoral transcatheter aortic valve implantation (TAVI) with the strong focus on guiding the double-filter cerebral embolic protection device and valve prosthesis placement. Methods In 31 patients undergoing TAVI, image registration of CTA-derived 3D anatomical models of the relevant cardiac anatomy and vasculature, and live XR was performed applying a commercially available navigation tool. The approach was evaluated in terms of the accuracy of the overlay. In 27 TAVI patients with IF receiving double-filter cerebral embolic protection device overall procedure time, fluoroscopy time, radiation dose, and total volume of intra-procedural iodinated contrast agent (CA) were registered and compared to those of a control group of prospectively enrolled during the same period of time N=27 patients receiving the same protection system but without IF. Results and conclusions Image co-registration and model-based guidance is feasible in TAVI procedures. The overlay facilitates placement of the embolic protection device, placement of the guide wire in the left ventricle and initial alignment of the valve prosthesis prior to final deployment, thus improving the confidence level of the operators during the procedure without compromising CA or XR dose.
- Subjects :
- Male
medicine.medical_specialty
Intraoperative Neurophysiological Monitoring
Transcatheter aortic
Image registration
Iodinated Contrast Agent
030204 cardiovascular system & hematology
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Fluoroscopy
Prospective Studies
030212 general & internal medicine
Embolic protection
medicine.diagnostic_test
business.industry
Aortic Valve Stenosis
Cone-Beam Computed Tomography
medicine.disease
Stenosis
medicine.anatomical_structure
Intracranial Embolism
Echocardiography
Ventricle
Angiography
Feasibility Studies
Female
Radiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 249
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....970071a469101a0e48d12634ae3bca06