Universität zu Köln

Madershahian, Navid, Weber, Carolyn, Majd, Payman, Rudolph, Tanja, Kuhn, Elmar, Scherner, Maximilian, Choi, Yeong-Hoon, Eghbalzadeh, Kaveh, Rudolph, Volker, Sahyoun, Cherif and Wahlers, Thorsten (2018). Feasibility and applicability of static vascular outline roadmapping during transcatheter aortic valve implantation. J. Cardiovasc. Surg., 59 (1). S. 111 - 115. TURIN: EDIZIONI MINERVA MEDICA. ISSN 1827-191X

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Abstract

BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips Vascular Outlining prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two-dimensional vessel margins as a roadmap on live fluoroscopy. Preoperational planning, sizing and anatomical assessment of access routes were performed using computed tomography scans and the Philips HeartNavigator software. RESULTS: Fifteen high-risk aortic stenosis patients (mean age 82.0 +/- 6.6 years) underwent TAVI via transfemoral (N.=8), transapical (N.=4), and transaortic (N.=3) access routes. Mean logistic EuroSCOREs and STS-scores were 19.7 +/- 4.3% and 7.9 +/- 3.1%, respectively, mean aortic gradient was 66.3 +/- 18.3 mmHg. All valves were implanted successfully with none or trivial paravalvular regurgitation in 11 patients, mild in 3 patients, and moderate in 1 patient. TAVI was performed in all cases with only one aortic root contrast media injection during valve deployment. No major stroke or cardiovascular death occurred within 30 days. CONCLUSIONS: Vascular Outlining- guided implantation of the SapienXT valve is feasible. This new feature might increase the accuracy of valve placement and also may reduce the need for extra contrast media use during valve deployment. However, the lack of real-time motion compensation limits its wide application, as the overlay does not move together with respiratory and cardiac motion.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Majd, Payman UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Sahyoun, Cherif UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-197021
DOI:	10.23736/S0021-9509.17.10095-9
Journal or Publication Title:	J. Cardiovasc. Surg.
Volume:	59
Number:	1
Page Range:	S. 111 - 115
Date:	2018
Publisher:	EDIZIONI MINERVA MEDICA
Place of Publication:	TURIN
ISSN:	1827-191X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEP-BY-STEP; REPLACEMENT; DYNACT; ROOT Multiple languages Cardiac & Cardiovascular Systems; Surgery; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19702