Aktuelle Kardiologie 2016; 5(01): 22-26
DOI: 10.1055/s-0041-109628
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Hybride interventionelle Bildgebung

Hybrid Fusion Imaging
V. Veulemans
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf
,
J. Balzer
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf
,
T. Zeus
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2016 (online)

Zusammenfassung

Der intraprozedurale Erfolg von Interventionen hängt von einer sinnvollen Kombination aus Fluoroskopie, 3D-rekonstruierten MSCT-Datensätzen sowie dem Einsatz 2D- und 3D-gestützter Echokardiografie ab. Vorteile bestehen hier in dem zusätzlichen Informationsgehalt der bildgebenden Modalitäten hinsichtlich Präzision der anatomischen und geometrischen Erfassung komplexer Herzstrukturen. Da diese Informationen nicht alleine durch die Fluoroskopie bereitgestellt werden können, hat der Einsatz der hybriden Fusionsbildgebung in der interventionellen Kardiologie das Potenzial, die prozedurale Sicherheit sowie die Effektivität hinsichtlich Device-Platzierung zu steigern. Diese Innovation ermöglicht zudem eine Limitation von Strahlendosis sowie eingesetzter Kontrastmittelmenge.

Abstract

The procedural success of interventions in structural heart disease depends on adequate peri-interventional imaging using a combination of fluoroscopy, MSCT-data with 3D-reconstruction and echocardiography. The major advantage of peri-interventional imaging consists in the optimized view of the cardiac structures and the monitoring of the entire procedure with an excellent spatial resolution. Because soft-tissue informations cannot be provided by fluoroscopy alone, hybrid fusion imaging has the potential to increase safety, accuracy and procedural effectiveness in interventional cardiology.

 
  • Literatur

  • 1 Delgado V, Kapadia S, Schalij MJ et al. Transcatheter aortic valve implantation: implications of multimodality imaging in patient selection, procedural guidance, and outcomes. Heart 2012; 98: 743-754
  • 2 Delgado V, Kapadia S, Marsan NA et al. Multimodality imaging before, during, and after percutaneous mitral valve repair. Heart 2011; 97: 1704-1714
  • 3 Jilaihawi H, Kashif M, Fontana G et al. Cross-sectional computed tomographic assessment improves accuracy of aortic annular sizing for transcatheter aortic valve replacement and reduces the incidence of paravalvular aortic regurgitation. J Am Coll Cardiol 2012; 59: 1275-1286
  • 4 Balzer JC, Boering YC, Mollus S et al. Left ventricular contrast injection with rotational C-arm CT improves accuracy of aortic annulus measurement during cardiac catheterisation. EuroIntervention 2014; 10: 347-354
  • 5 Zamorano JL, Badano LP, Bruce C et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. Eur Heart J 2011; 32: 2189-2214
  • 6 Bloomfield GS, Gillam LD, Hahn RT et al. A practical guide to multimodality imaging of transcatheter aortic valve replacement. JACC Cardiovas Imaging 2012; 5: 441-455
  • 7 Kliger C, Jelnin V, Sharma S et al. CT angiography-fluoroscopy fusion imaging for percutaneous transapical access. JACC Cardiovas Imaging 2014; 7: 169-177
  • 8 Sündermann SH, Biaggi P, Grünenfelder J et al. Safety and feasibility of novel technology fusing echocardiography and fluoroscopy images during MitraClip interventions. EuroIntervention 2013; 9: 1210-1216
  • 9 Corti R, Biaggi P, Gaemperli O et al. Integrated x-ray and echocardiography imaging for structural heart interventions. EuroIntervention 2013; 9: 863-869
  • 10 Achenbach S, Delgado V, Hausleiter J et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr 2012; 6: 366-380
  • 11 Kasel AM, Cassese S, Bleiziffer S et al. Standardized imaging for aortic annular sizing: implications for transcatheter valve selection. JACC Cardiovas Imaging 2013; 6: 249-262
  • 12 Binder RK, Leipsic J, Wood D et al. Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography. Circ Cardiovasc Interv 2012; 5: 247-252
  • 13 Samim M, Agostoni P, Nijhoff F et al. Three-dimensional aortic root reconstruction derived from rotational angiography for transcatheter balloon-expandable aortic valve implantation guidance. Int J Cardiol 2014; 176: 1318-1320
  • 14 Samim M, Stella PR, Agostoni P et al. Automated 3D analysis of pre-procedural MDCT to predict annulus plane angulation and C-arm positioning: benefit on procedural outcome in patients referred for TAVR. JACC Cardiovas Imaging 2013; 6: 238-248
  • 15 Balzer J, Zeus T, Blehm A et al. Intraprocedural online fusion of echocardiography and fluoroscopy during transapical mitral valve-in-valve implantation. Can J Cardiol 2015; 31: 364.e9-364.e11