Feasibility and Safety of Using a Fused Echocardiography/Fluoroscopy Imaging System in Patients with Congenital Heart Disease

Jone, Pei‐Ni; Ross, Michael; Bracken, John; Mulvahill, Matthew; Maria, Michael V. Di; Fagan, Thomas E.

doi:10.1016/j.echo.2016.03.014

Cited by 55 publications

(37 citation statements)

References 12 publications

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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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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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“…29 Furthermore, TEE-XRF significantly decreased both fluoroscopy time and radiation dose. Besides septal defect closures, TSP is a procedural step in e.g.…”

Section: Solutions For Septal Defect Closuresmentioning

confidence: 99%

“…30,31 Philips' EchoNavigator guided MitraClip procedures versus conventional TEE-XRF guided MitraClip procedures showed no differences in procedure time and radiation exposure, although a trend towards shorter procedure time was observed. 29,30 Interestingly, EchoNavigator allowed faster placement of two or more clips decreasing the time until the second or third clip by 6 min (83.2 ± 27.4 vs. 88.9 ± 29.0 min, p = 0.6) and 60 min (134.2 ± 23.2 vs. 199.5 ± 72.8 min, p = 0.4) minutes, respectively. 30 There is no literature on the use of Siemens' TrueFusion TEE-XRF fusion software in cardiac procedures.…”

Section: Different Implementations For Mitral Valve Interventionsmentioning

confidence: 99%

“…Potentially a larger beneficial effect can be expected when more experience with TEE-XRF is gained. 29,30 Quantification of the effect of operator experience, however, requires studies with larger cohorts.…”

Section: Operator Experience In Hi Solutionsmentioning

confidence: 99%

“…8,29 The TEE transducer is automatically tracked in the live XRF images and the 3D echocardiographic images are fused with the XRF images. Demarcations of important soft tissue structures made in the echo images are shown on the live images.…”

Section: Different Implementations For Mitral Valve Interventionsmentioning

confidence: 99%

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3D Hybrid Imaging for Structural and Congenital Heart Interventions in the Cath Lab

Broek

Krings

et al. 2018

Structural Heart

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Hybrid imaging (HI) during cardiovascular interventions enables the peri-procedural visualization of the organs and tissues by means of integrating different imaging modalities. HI can improve the procedural efficacy and safety. This review provides an overview of different systems, their possibilities and the current clinical use and benefits focused on structural and congenital heart diseases. We have performed a literature search and linked the software options to the clinical use in cardiology to gain insight into the clinical use of the systems. In this review, we focus on radiation and contrast exposure, complication rate and procedure time. We found that currently available studies are limited by small cohorts. Nevertheless, HI systems for valvular procedures result in a significant decrease of radiation and contrast exposure. The largest benefit hereof is observed when HI is used in combination with rotational angiography. Furthermore, automatically determined optimal implant angle for transcatheter aortic valve implantation decreases the complication rate significantly. Congenital heart disease interventions that require 2D/3D Transoesophageal echocardiography (TEE) such as septal defects show a significant decrease in radiation and contrast exposure and procedural time when using TEE-Mono-and bi-plane cine angiography and fluoroscopy (XRF) fusion software. MitraClip procedures using these HI systems, however, show only a trend in decrease of these effects. In conclusion, major interventional X-ray vendors offer HI software solutions which are safe and can aid the planning and image guidance of cardiovascular interventions. Even though current HI technologies have limitations, HI provides support in the increasingly complex cardiac interventional procedures to provide better patient care.

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Echocardiography

Brown,

Jone,

Patel

et al. 2023

Pediatric Cardiology

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Feasibility and Safety of Using a Fused Echocardiography/Fluoroscopy Imaging System in Patients with Congenital Heart Disease

Cited by 55 publications

References 12 publications

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

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

3D Hybrid Imaging for Structural and Congenital Heart Interventions in the Cath Lab

Echocardiography

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