New imaging software from Siemens simplifies workflow for minimally invasive heart valve implantation

At ESC, Siemens presents a new image processing software that helps cardiologists and cardiac surgeons prepare and perform transcatheter aortic valve implantations (TAVI): Syngo Aortic ValveGuide automatically reconstructs a 3D representation of the aortic root from CT-like cross-sectional images acquired with the angiography system.

To find the right C-arm angulation for the TAVI (Transcatheter aortic valve...
To find the right C-arm angulation for the TAVI (Transcatheter aortic valve implantation) procedure, the software Syngo Aortic ValveGuide derives a circle parallel to the plane spanned by the three lowest points of the aortic valve cusps. This circle degenerates to a straight line when the three lowest cusp points are aligned, which indicates that the optimal perpendicular angulation has been reached

The software selects anatomical landmarks as the coronary ostia, for instance, and overlays the 3D image with two-dimensional images acquired during live fluoroscopy. That way, the physician obtains real-time, three-dimensional guidance in the patient’s body while navigating the new valve to its intended location.

During the minimally invasive TAVI (transcatheter aortic valve implantation) intervention, an
artificial aortic valve is inserted via the femoral artery or through the apex of the heart. A new
image processing software from provides the physician automated 3D guidance for the procedure: Syngo Aortic ValveGuide segments the aortic root in three-dimensional mode from Syngo DynaCT Cardiac images. With the aid of anatomical landmarks in the 3D representation of the vessel, Syngo Aortic ValveGuide calculates the exact perpendicular view on the aortic root. The C-arm adjusts to the corresponding angulations for live fluoroscopy. That way, it provides the proper perspective that the physician requires to exactly position the new valve. Consequently, as soon as the software overlays the 3D image of the aorta with the two-dimensional live fluoroscopy, the cardiologist in the cath lab or, respectively, the heart surgeon in the hybrid room, can start the intervention. Since Syngo Aortic ValveGuide only requires a short fluoroscopy time prior to the procedure, the patient's exposure to radiation and contrast agent can be reduced considerably.

The Heart Center in Leipzig, one of the leading facilities in Germany to perform TAVI-procedures, had previously performed several of these interventions with the Syngo DynaCT Cardiac from Siemens. This software processes CT-like images of the heart from images acquired with the angiography system. However, to overlay live fluoroscopy images with these 3D images and find the correct angulation for the C-arm, the physician had to leave the sterile operating area and perform manual angulation calculations at a workstation – or make medical staff available solely for this purpose. "With Syngo Aortic ValveGuide, we can now find the optimal angulation with a perpendicular view on the aortic root easier and faster than before, because the software automates so many work steps,” says Dr. Jörg Kempfert, heart surgeon at the Heart Center Leipzig
 

30.08.2010

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