Use of short roll C-arm computed tomography and fully automated 3D analysis tools to guide transcatheter aortic valve replacement

Determination of the coplanar view is a critical component of transcatheter aortic valve replacement (TAVR). The safety and accuracy of a novel reduced angular range C-arm computed tomography (CACT) approach coupled with a fully automated 3D analysis tool package to predict the coplanar view in TAVR...

Full description

Saved in:
Bibliographic Details
Published in:International Journal of Cardiovascular Imaging 2016-07, Vol.32 (7), p.1145-1152
Main Authors: Kim, Michael S., Bracken, John, Eshuis, Peter, Chen, S. Y. James, Fullerton, David, Cleveland, Joseph, Messenger, John C., Carroll, John D.
Format: Article
Language:English
Subjects:
Aortic Valve - diagnostic imaging
Aortic Valve - physiopathology
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - physiopathology
Aortic Valve Stenosis - therapy
Aortography - methods
Automation
Cardiac Catheterization - adverse effects
Cardiac Catheterization - instrumentation
Cardiac Catheterization - methods
Cardiac Imaging
Cardiology
Computed Tomography Angiography
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Heart Valve Prosthesis Implantation - methods
Humans
Imaging
Imaging, Three-Dimensional
Medicine
Medicine & Public Health
Multidetector Computed Tomography
Original Paper
Predictive Value of Tests
Radiation Dosage
Radiation Exposure
Radiographic Image Interpretation, Computer-Assisted
Radiography, Interventional - methods
Radiology
Severity of Illness Index
Software
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Determination of the coplanar view is a critical component of transcatheter aortic valve replacement (TAVR). The safety and accuracy of a novel reduced angular range C-arm computed tomography (CACT) approach coupled with a fully automated 3D analysis tool package to predict the coplanar view in TAVR was evaluated. Fifty-seven patients with severe symptomatic aortic stenosis deemed prohibitive-risk for surgery and who underwent TAVR were enrolled. Patients were randomized 2:1 to CACT vs. angiography (control) in estimating the coplanar view. These approaches to determine the coplanar view were compared quantitatively. Radiation doses needed to determine the coplanar view were recorded for both the CACT and control patients. Use of CACT offered good agreement with the actual angiographic view utilized during TAVR in 34 out of 41 cases in which a CACT scan was performed (83 %). For these 34 cases, the mean angular magnitude difference, taking into account both oblique and cranial/caudal angulation, was 1.3° ± 0.4°, while the maximum difference was 7.3°. There were no significant differences in the mean total radiation dose delivered to patients between the CACT and control groups as measured by either dose area product (207.8 ± 15.2 Gy cm 2 vs. 186.1 ± 25.3 Gy cm 2 , P = 0.47) or air kerma (1287.6 ± 117.7 mGy vs. 1098.9 ± 143.8 mGy, P = 0.32). Use of reduced-angular range CACT coupled with fully automated 3D analysis tools is a safe, practical, and feasible method by which to determine the optimal angiographic deployment view for guiding TAVR procedures.
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-016-0886-0