Abstract
IntroductionThree-dimensional rotational angiography (3DRA) has been used in the guidance of various transcatheter therapies including percutaneous pulmonary valve implantation (PPVI). The most recently available 3D image fusion software (VesselNavigator, Philips) extends this technology to use pre-registered computed tomography or magnetic resonance imaging datasets, promising reductions in contrast and radiation exposure along with shorter procedural times.MethodsIn this retrospective review, patients were assigned to three groups according to the mode of imaging guidance: two-dimensional angiography (2DA), 3DRA and VesselNavigator (VN) assisted valve implantation. Patient characteristics and catheterisation data were reviewed with a focus on contrast and radiation exposure, fluoroscopy, and procedural times.ResultsBetween July 2012 and June 2016, 21 patients underwent PPVI: 8 with 2D guidance, 6 patients with 3DRA and most recently 7 patients with VN assistance. Patents in the VN group received significantly less absolute and weight indexed contrast when compared with those with 2DA or 3DRA guided PPVI. Patients in the 2DA group received a significantly higher total dose area product radiation dose and air kerma in comparison with patients with 3DRA and VN guided intervention. Application of VN resulted in the shortest fluoroscopy time, although not statistically significant, and a significantly shorter study time when compared with 2DA.ConclusionsUtilisation of pre-intervention image manipulation with VesselNavigator for 3D guidance of PPVI results in a reduction in contrast and radiation exposure and study time as compared with traditional 2D guidance, and contrast usage as compared with 3DRA.
Highlights
Three-dimensional rotational angiography (3DRA) has been used in the guidance of various transcatheter therapies including percutaneous pulmonary valve implantation (PPVI)
The development of fusion imaging software has led to the introduction of three-dimensional rotational angiography (3DRA) for the guidance of various transcatheter therapies, including PPVI [9,10,11,12]
Patients were assigned to three groups according to the mode of imaging guidance: two-dimensional angiography (2DA), 3DRA (Phillips Allura XPER FD20) and VesselNavigator (VN) assisted valve implantation
Summary
Three-dimensional rotational angiography (3DRA) has been used in the guidance of various transcatheter therapies including percutaneous pulmonary valve implantation (PPVI). The most recently available 3D image fusion software (VesselNavigator, Philips) extends this technology to use pre-registered computed tomography or magnetic resonance imaging datasets, promising reductions in contrast and radiation exposure along with shorter procedural times. Over the last 15 years, percutaneous pulmonary valve implantation (PPVI) has become an effective and less invasive alternative to surgical right ventricle-to-pulmonary artery conduit replacement [1,2,3]. The development of fusion imaging software has led to the introduction of three-dimensional rotational angiography (3DRA) for the guidance of various transcatheter therapies, including PPVI [9,10,11,12]. The most recently available 3D image fusion software (VesselNavigator, Philips), which
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