A planning system for transapical aortic valve implantation

Michael Gessat; Denis R. Merk; Volkmar Falk; Thomas Walther; Stefan Jacobs; Alois Nöttling; Oliver Burgert

doi:10.1117/12.810270

13 March 2009 A planning system for transapical aortic valve implantation

Michael Gessat, Denis R. Merk, Volkmar Falk, Thomas Walther, Stefan Jacobs, Alois Nöttling, Oliver Burgert

Proceedings Volume 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling; 72611E (2009) https://doi.org/10.1117/12.810270
Event: SPIE Medical Imaging, 2009, Lake Buena Vista (Orlando Area), Florida, United States

Abstract

Stenosis of the aortic valve is a common cardiac disease. It is usually corrected surgically by replacing the valve with a mechanical or biological prosthesis. Transapical aortic valve implantation is an experimental minimally invasive surgical technique that is applied to patients with high operative risk to avoid pulmonary arrest. A stented biological prosthesis is mounted on a catheter. Through small incisions in the fifth intercostal space and the apex of the heart, the catheter is positioned under flouroscopy in the aortic root. The stent is expanded and unfolds the valve which is thereby implanted into the aortic root. Exact targeting is crucial, since major complications can arise from a misplaced valve. Planning software for the perioperative use is presented that allows for selection of the best fitting implant and calculation of the safe target area for that implant. The software uses contrast enhanced perioperative DynaCT images acquired under rapid pacing. In a semiautomatic process, a surface segmentation of the aortic root is created. User selected anatomical landmarks are used to calculate the geometric constraints for the size and position of the implant. The software is integrated into a PACS network based on DICOM communication to query and receive the images and implants templates from a PACS server. The planning results can be exported to the same server and from there can be rertieved by an intraoperative catheter guidance device.

Citation Download Citation

Michael Gessat, Denis R. Merk, Volkmar Falk, Thomas Walther, Stefan Jacobs, Alois Nöttling, and Oliver Burgert "A planning system for transapical aortic valve implantation", Proc. SPIE 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling, 72611E (13 March 2009); https://doi.org/10.1117/12.810270

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