Page 18 - Journal of Structural Heart Disease Volume 5, Issue 2

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Original Scientific Article
Table 3. Procedural Characteristics.
Fluoroscopic camera Siemens Cios Alpha Ziehm Vision RFD
GE OEC 9900 Elite
GE Advantx DLX
Philips Allura Xper FD20 Siemens Artis zee biplane
Valve type Sapien XT
Sapien 3 CoreValve Evolut
Valve size, mm 23
26 29
Alternative vascular access Transaortic
Transapical Transsubclavian
Radiation dose DAP, cGy*cm2
Air kerma, mGy
Excessive radiation exposure« Fluoroscopy time, min
Values are number (%) and mean ± SD. «Defined as DAP > 13310 cGy*cm2. DAP = dose area product.
17 (70.8) 5 (20.8) 2 (8.3) -
-
-
4 (16.7) 14 (58.3) 6 (25.0)
9 (37.5) 7 (29.2) 8 (33.3)
1 (4.2) 4 (16.7) 1 (4.2)
6566 ± 3335 371 ± 145 1 (5.0)
17 ± 7
-
-
-
62 (80.5) 13 (16.9) 2 (2.6)
33 (42.9) 34 (44.2) 10 (13.0)
27 (35.1) 25 (32.5) 25 (32.5)
0 (0.0) 0 (0.0) 1 (1.3)
9016 ± 7745 683 ± 534 4 (26.7) 21 ± 13
-
0.053
0.95
0.001
0.27 0.043 0.14 0.16
Characteristic
Portable Angiography System
(n = 24)
Mounted Angiography System
(n = 77)
P Value
cacy to a traditional MAS. We observed no statistically significant differences in rates of mortality, ischemic stroke, life threatening or major bleeding, vascular complication requiring intervention, pacemaker im- plantation, or rehospitalization. Additionally, both groups had similar improvement in NYHA class symp- toms and degree of PVL. For the composite safety outcome of any adverse event at 30 days and for mortality at 1 year, the two study groups had compa- rable event-free survival. As a result of these findings, we believe PAS can be used as an alternative to MAS during TAVR.
Overall, the features of new generation PAS fluoro- scopic systems compare well to those of MAS systems, which may explain, in part, why the two study groups experienced similar clinical outcomes. The specifica- tionsofthePAScamerasandthenewestMAScamera used in this study (the FD20) are compared in Table 5.
All three PAS cameras offer radiation dose monitor- ing and reduction features comparable to the FD20 ClarityIQ, Doseaware, SpectraBeam, and MRC-GS 0407 technologies [27-29]. Like the FD20, the GE9900 and RFD cameras offer high frequency X-ray generators, while the Cios Alpha generator uses a monoblock de-
Ahmed B. et al.
TAVR Using Portable Fluoroscopy