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1篇 您的检索式:作者名="Axel Saalbach"
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1Optimal C-arm angulation during transcatheter aortic valve replacement: Accuracy of a rotational C-arm computed tomography based three dimensional heart model显示文摘AIM To investigate the accuracy of a rotational C-arm CTbased 3D heart model to predict an optimal C-arm configuration during transcatheter aortic valve replacement(TAVR). METHODS Rotational C-arm CT(RCT) under rapid ventricular pacing was performed in 57 consecutive patients with severe aortic stenosis as part of the pre-procedural cardiac catheterization. With prototype software each RCT data set was segmented using a 3D heart model. From that the line of perpendicularity curve was obtained that generates a perpendicular view of the aortic annulus according to the right-cusp rule. To evaluate the accuracy of a model-based overlay we compared model- and expert-derived aortic root diameters. RESULTS For all 57 patients in the RCT cohort diameter measurements were obtained from two independent operators and were compared to the model-based measurements. The inter-observer variability was measured to be in the range of 0°-12.96° of angular C-arm displacement for two independent operators. The model-to-operator agreement was 0°-13.82°. The model-based and expert measurements of aortic root diameters evaluated at the aortic annulus(r = 0.79, P < 0.01), the aortic sinus(r = 0.93, P < 0.01) and the sino-tubular junction(r = 0.92, P < 0.01) correlated on a high level and the Bland-Altman analysis showed good agreement. The interobserver measurements did not show a significant bias. CONCLUSION Automatic segmentation of the aortic root using an anatomical model can accurately predict an optimal C-arm configuration, potentially simplifying current clinical workflows before and during TAVR.Verena Veulemans Sabine Mollus Axel Saalbach Max Pietsch Katharina Hellhammer Tobias Zeus Ralf Westenfeld Jürgen Weese Malte Kelm Jan Balzer 2016World Journal of Cardiology2016,8,10:0
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