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- Title
A new approach of three-dimensional guidance in paediatric cath lab: segmented and tessellated heart models for cardiovascular interventions in CHD.
- Authors
Ehret, Nicole; Alkassar, Muhannad; Dittrich, Sven; Glöckler, Martin; Cesnjevar, Robert; Rüffer, André; Uder, Michael; Rompel, Oliver; Hammon, Matthias; Rüffer, André; Glöckler, Martin
- Abstract
<bold>Background: </bold>Optimal imaging is essential for catheter-based interventions in CHD. The three-dimensional models in volume-rendering technique currently in use are not standardised. This paper investigates the feasibility and impact of novel three-dimensional guidance with segmented and tessellated three-dimensional heart models in catheterisation of CHD. In addition, a nearly radiation-free two- to three-dimensional registration and a biplane overlay were used.Methods and resultsWe analysed 60 consecutive cases in which segmented tessellated three-dimensional heart models were merged with live fluoroscopy images and aligned using the tracheal bifurcation as a fiducial mark. The models were generated from previous MRI or CT by dedicated medical software. We chose the stereo-lithography format, as this promises advantage over volume-rendering-technique models regarding visualisation. Prospects, potential benefits, and accuracy of the two- to three-dimensional registration were rated separately by two paediatric interventionalists on a five-point Likert scale. Fluoroscopy time, radiation dose, and contrast dye consumption were evaluated. Over a 10-month study period, two- to three-dimensional image fusion was applied to 60 out of 354 cases. Of the 60 catheterisations, 73.3% were performed in the context of interventions. The accuracy of two- to three-dimensional registration was sufficient in all cases. Three-dimensional guidance was rated superior to conventional biplane imaging in all 60 cases. We registered significantly smaller amounts of used contrast dye (p<0.01), lower levels of radiation dose (p<0.02), and less fluoroscopy time (p<0.01) during interventions concerning the aortic arch compared with a control group.<bold>Conclusions: </bold>Two- to three-dimensional image fusion can be applied successfully in most catheter-based interventions of CHD. Meshes in stereo-lithography format are accurate and base for standardised and reproducible three-dimensional models.
- Subjects
CATHETERIZATION; CARDIOVASCULAR disease diagnosis; HEART models; FLUOROSCOPY; MAGNETIC resonance imaging; CARDIAC catheterization; COMPUTED tomography; COMPUTER simulation; CONGENITAL heart disease; DIAGNOSTIC imaging; CARDIAC surgery; LONGITUDINAL method; RESEARCH evaluation; THREE-dimensional imaging; COMPUTER-assisted surgery; SURGERY
- Publication
Cardiology in the Young, 2018, Vol 28, Issue 5, p661
- ISSN
1047-9511
- Publication type
journal article
- DOI
10.1017/S1047951117002840