Page 15 - Journal of Structural Heart Disease Volume 4, Issue 5

New Technology
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A major limitation of the study design was the post-processing of data. Actual clinical use of motion compensation is needed to determine the impact of the motion compensated anatomical roadmap on valve positioning. Another limitation of the technolo- gy is its dependence on the pigtail catheter maintain- ing its position locked in one of the aortic valve cusps. It is important not to lose this position as the device is advanced, as the relationship between the pigtail and the valve plane is assumed constant. Whereas this is common in clinical practice during valve positioning, the pigtail is typically pulled in the last phases of de- ployment, implying that the motion compensated overlay may not be used for guidance if any final ad- justments are required. Further studies are warranted to examine whether these limitations are clinically acceptable. Of note, the live overlay is automatically disabled when detecting pigtail retrieval, to avoid er- roneous guidance.
The implications of this work are perhaps greatest for enhancing the learning curve amongst new op- erators and for physicians performing TAVIs on low- er-risk patients with potentially fewer X-ray-visible anatomic landmarks. Prospective studies of impact of this technology on contrast usage and positioning accuracy are warranted.
Conclusion
We have shown feasibility of the first fully auto- mated motion compensation method for real-time
continuous visualization of the target aortic anatomy during TAVI procedures. Our method has the poten- tial to improve valve positioning accuracy and reduc- tion in deployment variability and contrast usage.
Conflict of Interest
• Nick Assink – Master student located at Philips Healthcare)
• Maria-Louisa Izamis – Employee of Philips Healthcare • Olivier Nempont – Employee of Philips Healthcare • Marco Verstege – Employee of Philips Healthcare
• Cherif P. Sahyoun – Employee of Philips Healthcare • Alexander Haak – Employee of Philips Healthcare
• John D. Carroll – Research funding and in-kind sup- port from Philips Healthcare
• John C. Messenger – Research funding and in-kind support from Philips Healthcare
• Gerhard Schymik – In-kind support from Philips Healthcare
• Navid Madershahian – In-kind support from Philips Healthcare
• Thorsten C. Wahlers – In-kind support from Philips Healthcare
• Peter G. Eshuis – Employee of Philips Healthcare
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Journal of Structural Heart Disease, October 2018
Volume 4, Issue 5:207-211