CT Angiography–Fluoroscopy Fusion Imaging for Percutaneous Transapical Access

Kliger, Chad; Jelnin, Vladimir; Sharma, Sonnit; Panagopoulos, Georgia; Einhorn, Bryce; Kumar, Robert; Cuesta, Francisco; Maranan, Leandro; Kronzon, Itzhak; Carelsen, Bart; Cohen, Howard A.; Perk, Gila; Boomen, Rob Van Den; Sahyoun, Cherif; Ruiz, Carlos E.

doi:10.1016/j.jcmg.2013.10.009

Cited by 62 publications

(22 citation statements)

References 12 publications

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“…guidance has been utilized for directed transcatheter access, as well as for procedural interventions in the treatment of both valvular and paravalvular regurgitation(28)(29)(30)(31).TRANSCATHETER THERAPIES FOR AR NATIVE VALVES. Currently, there are no approved THVs for the treatment of native valve AR in the United States.…”

mentioning

confidence: 99%

Transcatheter Therapies for the Treatment of Valvular and Paravalvular Regurgitation in Acquired and Congenital Valvular Heart Disease

Ruiz

Kliger

Perk

et al. 2015

Journal of the American College of Cardiology

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Transcatheter therapies in structural heart disease have evolved tremendously over the past 15 years. Since the introduction of the first balloon-expandable valves for stenotic lesions with implantation in the pulmonic position in 2000, treatment for valvular heart disease in the outflow position has become more refined, with newer-generation devices, alternative techniques, and novel access approaches. Recent efforts into the inflow position and regurgitant lesions, with transcatheter repair and replacement technologies, have expanded our potential to treat a broader, more heterogeneous patient population. The evolution of multimodality imaging has paralleled these developments. Three- and 4-dimensional visualization and concomitant use of novel technologies, such as fusion imaging, have supported technical growth, from pre-procedural planning and intraprocedural guidance, to assessment of acute results and follow-up. A multimodality approach has allowed operators to overcome many limitations of each modality and facilitated integration of a multidisciplinary team for treatment of this complex patient population.

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confidence: 99%

Transcatheter Therapies for the Treatment of Valvular and Paravalvular Regurgitation in Acquired and Congenital Valvular Heart Disease

Ruiz

Kliger

Perk

et al. 2015

Journal of the American College of Cardiology

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“…This prospective study aims to determine whether XFM guidance is beneficial for prespecified select congenital heart disease interventions. Other groups have explored X‐ray fused with CT, X‐ray fused with 3DRA, and X‐ray fused with ultrasound . Each has potential benefits and drawbacks.…”

Section: Discussionmentioning

confidence: 99%

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

Grant

Kanter

Olivieri

et al. 2019

Cathet Cardio Intervent

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Objectives To determine whether X‐ray fused with MRI (XFM) is beneficial for select transcatheter congenital heart disease interventions. Background Complex transcatheter interventions often require three‐dimensional (3D) soft tissue imaging guidance. Fusion imaging with live X‐ray fluoroscopy can potentially improve and simplify procedures. Methods Patients referred for select congenital heart disease interventions were prospectively enrolled. Cardiac MRI data was overlaid on live fluoroscopy for procedural guidance. Likert scale operator assessments of value were recorded. Fluoroscopy time, radiation exposure, contrast dose, and procedure time were compared to matched cases from our institutional experience. Results Forty‐six patients were enrolled. Pre‐catheterization, same day cardiac MRI findings indicated intervention should be deferred in nine patients. XFM‐guided cardiac catheterization was performed in 37 (median age 8.7 years [0.5–63 years]; median weight 28 kg [5.6–110 kg]) with the following prespecified indications: pulmonary artery (PA) stenosis (n = 13), aortic coarctation (n = 12), conduit stenosis/insufficiency (n = 9), and ventricular septal defect (n = 3). Diagnostic catheterization showed intervention was not indicated in 12 additional cases. XFM‐guided intervention was performed in the remaining 25. Fluoroscopy time was shorter for XFM‐guided intervention cases compared to matched controls. There was no significant difference in radiation dose area product, contrast volume, or procedure time. Operator Likert scores indicated XFM provided useful soft tissue guidance in all cases and was never misleading. Conclusions XFM provides operators with meaningful three‐dimensional soft tissue data and reduces fluoroscopy time in select congenital heart disease interventions.

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“…This case was a clear demonstration of the potential benefit of integrating the output of different imaging modalities even though the coregistration system (radiopaque measuring tapes) is an extremely basic one. More elegant forms of co-registration that have recently been achieved include that between: 1) low-powered electromagnetic field global positioning system and fluoroscopy [10], 2) computed tomography and fluoroscopy [11], and 3) ultrasound and computed tomography [12][13][14]. Regarding peripheral endovascular procedures the ideal set up would be an integrated, automated, co-registration between ultrasonography and low-powered electromagnetic field global positioning system.…”

Section: Discussionmentioning

confidence: 99%

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Ephrem

Garikipati

Hanson

2016

Cardiovascular Revascularization Medicine

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CT Angiography–Fluoroscopy Fusion Imaging for Percutaneous Transapical Access

Abstract: With the use of CTA-fluoroscopy fusion imaging to guide TA, the actual puncture site can be approximated near the PPS. Moreover, fusion imaging can help maintain an adequate access distance from the left anterior descending artery, thereby, potentially reducing TA-related complications.

Cited by 62 publications

References 12 publications

Transcatheter Therapies for the Treatment of Valvular and Paravalvular Regurgitation in Acquired and Congenital Valvular Heart Disease

Transcatheter Therapies for the Treatment of Valvular and Paravalvular Regurgitation in Acquired and Congenital Valvular Heart Disease

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

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