Why the study?
Does novel automated CT software (Valve ASSIST 2) provide reproducible and accurate aortic annulus assessment and intraprocedural imaging for TAVI in patients with severe aortic stenosis?
Does novel automated CT software (Valve ASSIST 2) provide reproducible and accurate aortic annulus assessment and intraprocedural imaging for TAVI in patients with severe aortic stenosis?
Novel automated CT software (Valve ASSIST 2) provides highly reproducible and accurate aortic root measurements and real-time intraprocedural fusion imaging during TAVI.
Answers are grounded in this paper and cite their sources.
May support automated MDCT fusion for TAVI planning; leaves open need for validation before routine use.
OBJECTIVES: Novel automated computed tomography (CT) software (Valve ASSIST 2) has been developed for transcatheter aortic valve implantation (TAVI), which not only provides three-dimensional (3D) reconstruction of multidetector (MD) CT images, but also enables intraprocedural real-time fusion of fluoroscopic and MDCT images. We aimed to clarify the reproducibility and accuracy of this software in the aortic annulus assessment and verify the potential of intraprocedural integrated MDCT imaging for TAVI. METHODS AND RESULTS: We examined 50 patients with severe aortic stenosis undergoing transfemoral TAVI. Aortic annulus measurements were performed using 3mensio and the novel planning software. For intraprocedural imaging, preoperative CT dataset was overlaid onto fluoroscopy with the fusion software. The two images were aligned using the aortic root anatomy visible on both modalities. Novel planning software provided excellent reproducibility for the measurement of aortic annulus area (intraobserver intraclass correlation coefficients [ICC] 0.959, interobserver ICC 0.941), and perimeter (intraobserver ICC 0.915, interobserver ICC 0.912). Excellent correlation was found between novel planning software and 3mensio (ICC 0.952 for aortic annulus area, and 0.923 for perimeter). Intraprocedural fusion image of CT aortography and fluoroscopic aortic root aortography generated by this novel software identified coronary orifices and the distribution of aortic valve calcification during the device positioning. Fusion image displayed coronary orifices after device implantation. CONCLUSIONS: Novel planning software showed excellent reproducibility and accuracy in the assessment of aortic root anatomy. Furthermore, the integrated 3D fusion image might have a potential as an intraprocedural imaging modality to contribute to the development of a safer TAVI procedure.
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Butter et al. (2018) studied this question.
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