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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
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Algorithm for systematic valve-crossing in transcatheter aortic valve implantation.
Mi Chen1,2, Jonathan Michel1, Barbara E Stähli1
1University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Summary
This review details techniques for crossing a stenotic aortic valve during transcatheter aortic valve implantation. It addresses challenges and provides guidance to minimize stroke risk and complications.
Area of Science:
- Interventional Cardiology
- Medical Device Technology
Background:
- Retrograde aortic valve crossing is critical for transcatheter aortic valve implantation (TAVI).
- This step is challenging, time-consuming, and linked to increased stroke risk and potential complications.
Purpose of the Study:
- To provide a systematic review of techniques for retrograde aortic valve crossing.
- To offer detailed guidance for performing this crucial TAVI step safely and effectively.
Main Methods:
- Systematic summarization of retrograde valve-crossing techniques.
- Step-by-step procedural guidance.
- Description of 3D anatomy in 2D fluoroscopy.
- Discussion of modified techniques for diverse anatomies.
Main Results:
- Challenges associated with retrograde valve-crossing are identified.
- A detailed, step-by-step approach to valve-crossing is presented.
- Anatomical considerations for fluoroscopic visualization are explained.
- Adaptations for specific patient anatomies are described.
Conclusions:
- Mastery of retrograde aortic valve crossing techniques is essential for successful TAVI.
- Understanding anatomical nuances and employing modified techniques can mitigate risks.
- This review serves as a guide for interventional cardiologists performing TAVI.
