3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions

Novel commercially available software has enabled registration of both CT and MRI images to rapidly fuse with X-ray fluoroscopic imaging. We describe our initial experience performing cardiac catheterisations with the guidance of 3D imaging overlay using the VesselNavigator system (Philips Healthcar...

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Bibliographic Details
Published in:Cardiology in the young 2020-05, Vol.30 (5), p.656-662
Main Authors: Arar, Yousef, Reddy, Surendranath R Veeram, Kim, Heidi, Dimas, V Vivian, Zellers, Thomas M, Abou Zahr, Riad, Vamsee, Ravi, Greer, Joshua S, Tandon, Animesh, Pontiki, Antonia, Dillenbeck, Jeanne, Zabala, Luis, Greil, Gerald, Nugent, Alan W, Hussain, Tarique
Format: Article
Language:English
Subjects:
Adolescent
Age
Angioplasty
Aorta
Benchmarks
Cameras
Cardiac catheterization
Cardiac Catheterization - methods
Catheters
Child
Child, Preschool
Complications
Computed tomography
Coronary vessels
Embolization
Female
Fistula
Fluoroscopic imaging
Heart
Heart Defects, Congenital - diagnostic imaging
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Implants
Infant
Infant, Newborn
Magnetic resonance imaging
Male
Medical imaging
Multimodal Imaging
Occlusion
Patients
Pulmonary arteries
Radiation
Radiation dosage
Radiation effects
Registration
Retrospective Studies
Software
Stents
Technology utilization
Veins & arteries
X ray imagery
Young Adult
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Description
Summary:Novel commercially available software has enabled registration of both CT and MRI images to rapidly fuse with X-ray fluoroscopic imaging. We describe our initial experience performing cardiac catheterisations with the guidance of 3D imaging overlay using the VesselNavigator system (Philips Healthcare, Best, NL). A total of 33 patients with CHD were included in our study. Demographic, advanced imaging, and catheterisation data were collected between 1 December, 2016 and 31 January, 2019. We report successful use of this technology in both diagnostic and interventional cases such as placing stents and percutaneous valves, performing angioplasties, occlusion of collaterals, and guidance for lymphatic interventions. In addition, radiation exposure was markedly decreased when comparing our 10-15-year-old coarctation of the aorta stent angioplasty cohort to cases without the use of overlay technology and the most recently published national radiation dose benchmarks. No complications were encountered due to the application of overlay technology. 3D CT or MRI overlay for CHD intervention with rapid registration is feasible and aids decisions regarding access and planned angiographic angles. Operators found intraprocedural overlay fusion registration using placed vessel guidewires to be more accurate than attempts using bony structures.
ISSN:1047-9511
1467-1107
DOI:10.1017/S1047951120000712