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Updated: Mar 23, 2026
06:59
Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
11.1K
Computed tomography optimised fluoroscopy guidance for transcatheter mitral therapies
Nicolas M Van Mieghem1, Ramón Rodríguez-Olivares, Ben C Ren
1Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Summary
Pre-procedural multislice computed tomography (MSCT) aids fluoroscopy guidance for transcatheter mitral valve interventions. This imaging technique helps localize unseen anatomy and optimize C-arm angles, potentially speeding up complex procedures.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- Transcatheter mitral valve interventions require precise anatomical visualization.
- Fluoroscopy guidance can be limited in localizing critical structures.
Purpose of the Study:
- To demonstrate the practical application of pre-procedural multislice computed tomography (MSCT) for enhancing fluoroscopy guidance in transcatheter mitral valve interventions.
Main Methods:
- Utilized dedicated software (3mensio Structural Heart) to analyze MSCT data.
- Identified and localized invisible anatomical landmarks (interatrial septum, paravalvular leaks, mitral leaflets).
- Determined optimal C-arm gantry angles for key procedural steps.
Main Results:
- MSCT enabled projection of anatomical targets onto fluoroscopy for improved needle guidance during transseptal puncture.
- Optimized C-arm angulation facilitated precise positioning of devices like MitraClip.
- Localized periprosthetic mitral leaks relative to the prosthesis.
Conclusions:
- Pre-procedural MSCT is a valuable adjunct to transesophageal echocardiography.
- Optimal C-arm angulations derived from MSCT aid in localizing anatomy via fluoroscopy.
- This approach may expedite complex transcatheter mitral interventions.
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