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Journal of Structural Heart Disease, October 2018, Volume 4, Issue 5:207-211
DOI: 10.12945/j.jshd.2018.050.17
Feasibility of Fully Automated Motion Compensated Overlay for Transcatheter Aortic Valve Implantation
Nick Assink, MSc1, Maria-Louisa Izamis, PhD2, Olivier Nempont, PhD3, Marco Verstege, PDEng1, Cherif P. Sahyoun, PhD1, Alexander Haak, PhD1, John D. Carroll, MD4, John C. Messenger, MD4, Gerhard Schymik, MD5, Navid Madershahian, MD6, Thorsten C. Wahlers, MD6, Peter Eshuis, PhD,1*
1 Philips Healthcare, Best, The Netherlands
2 Philips Research, Eindhoven, The Netherlands
3 Philips Research, Paris, France
4 Division of Cardiology, University of Colorado Hospital, Aurora, Colorado, USA
5 Municipal Hospital Karlsruhe, Karlsruhe, Germany
6 Department of Cardiac and Thoracic Surgery, Cologne University Heart Center, Cologne, Germany
Abstract
Background: Automated motion compensation of aortic root overlay on fluoroscopy during transcatheter aortic valve implantation (TAVI) could ensure accurate device positioning at minimal contrast cost, thereby reducing complication rates.
Objectives: To describe the feasibility of software that automatically compensates for cardiac and respiratory motion on X-ray, which may allow greater device control during TAVI.
Methods: Twenty four TAVI cases (25,607 frames) from four independent institutions using either the Medtronic CoreValve (n=8) or Edwards Sapien valve (n=16) were post-processed with the software. For each case, the algorithm applied three steps: (i) Generation of an anatomical roadmap using X-ray (Vascular Outlining, or VO) or 3D segmentation of CT data, (ii) Correlation to pigtail catheter, and (iii) Real-time motion compensation.
Results: VO motion compensation was activated 84% of all frames yielding a relative displacement error of -1.09 ± 2.65 mm. Similarly, CT-aided motion compensation was activated 84% of frames yielding a relative displacement error of -0.77 ± 2.92 mm.
Conclusions: We have shown feasibility of the first fully automated motion compensation method for real-time continuous visualization of the target aortic anatomy during TAVI procedures. Our method has the potential to improve valve positioning accuracy and reduction in deployment variability.
Cite this article as: Assink N, Izamis M, Nempont O, Verstege M, Sahyoun CP, Haak A, Carroll JD, Messenger JC, Schymik G, Madershahian N, Wahlers TC, Eshuis P. Feasibility of Fully Automated Motion Compensated Overlay for Transcatheter Aortic Valve Implantation. Structural Heart Disease 2018;4(5):207-211. DOI: 10.12945/j.jshd.2018.050.17
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New Technology
Journal of Structural Heart Disease, October 2018, Volume 4, Issue 5:207-211
DOI: 10.12945/j.jshd.2018.050.17
Feasibility of Fully Automated Motion Compensated Overlay for Transcatheter Aortic Valve Implantation
Nick Assink, MSc1, Maria-Louisa Izamis, PhD2, Olivier Nempont, PhD3, Marco Verstege, PDEng1, Cherif P. Sahyoun, PhD1, Alexander Haak, PhD1, John D. Carroll, MD4, John C. Messenger, MD4, Gerhard Schymik, MD5, Navid Madershahian, MD6, Thorsten C. Wahlers, MD6, Peter Eshuis, PhD,1*
1 Philips Healthcare, Best, The Netherlands
2 Philips Research, Eindhoven, The Netherlands
3 Philips Research, Paris, France
4 Division of Cardiology, University of Colorado Hospital, Aurora, Colorado, USA
5 Municipal Hospital Karlsruhe, Karlsruhe, Germany
6 Department of Cardiac and Thoracic Surgery, Cologne University Heart Center, Cologne, Germany
Abstract
Background: Automated motion compensation of aortic root overlay on fluoroscopy during transcatheter aortic valve implantation (TAVI) could ensure accurate device positioning at minimal contrast cost, thereby reducing complication rates.
Objectives: To describe the feasibility of software that automatically compensates for cardiac and respiratory motion on X-ray, which may allow greater device control during TAVI.
Methods: Twenty four TAVI cases (25,607 frames) from four independent institutions using either the Medtronic CoreValve (n=8) or Edwards Sapien valve (n=16) were post-processed with the software. For each case, the algorithm applied three steps: (i) Generation of an anatomical roadmap using X-ray (Vascular Outlining, or VO) or 3D segmentation of CT data, (ii) Correlation to pigtail catheter, and (iii) Real-time motion compensation.
Results: VO motion compensation was activated 84% of all frames yielding a relative displacement error of -1.09 ± 2.65 mm. Similarly, CT-aided motion compensation was activated 84% of frames yielding a relative displacement error of -0.77 ± 2.92 mm.
Conclusions: We have shown feasibility of the first fully automated motion compensation method for real-time continuous visualization of the target aortic anatomy during TAVI procedures. Our method has the potential to improve valve positioning accuracy and reduction in deployment variability.
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Cite this article as: Assink N, Izamis M, Nempont O, Verstege M, Sahyoun CP, Haak A, Carroll JD, Messenger JC, Schymik G, Madershahian N, Wahlers TC, Eshuis P. Feasibility of Fully Automated Motion Compensated Overlay for Transcatheter Aortic Valve Implantation. Structural Heart Disease 2018;4(5):207-211. DOI: 10.12945/j.jshd.2018.050.17
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