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3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions

Published online by Cambridge University Press:  15 April 2020

Yousef Arar Open the ORCID record for Yousef Arar [Opens in a new window] ,
Surendranath R. Veeram Reddy ,
Heidi Kim ,
V. Vivian Dimas ,
Thomas M. Zellers ,
Riad Abou Zahr ,
Ravi Vamsee ,
Joshua S. Greer ,
Animesh Tandon Open the ORCID record for Animesh Tandon [Opens in a new window]  and
Antonia Pontiki
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Yousef Arar*
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Surendranath R. Veeram Reddy
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Heidi Kim
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
V. Vivian Dimas
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Thomas M. Zellers
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Riad Abou Zahr
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Ravi Vamsee
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Joshua S. Greer
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Animesh Tandon
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA Department of Radiology, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Antonia Pontiki
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Jeanne Dillenbeck
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Luis Zabala
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Gerald Greil
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA Department of Radiology, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Alan W. Nugent
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA
Tarique Hussain
Affiliation:
Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, Dallas, TX, USA Department of Radiology, UT Southwestern Children’s Medical Center, Dallas, TX, USA
*
Author for correspondence: Y. Arar, Pediatric Cardiology, Department of Pediatrics, UT Southwestern Children’s Medical Center, 1935 Medical District Drive, Dallas, TX75235-7701, USA. Tel: +1 214 456 7311; Fax: +1 214 456 6154. E-mail: Yousef.Arar@UTSouthwestern.edu
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Abstract

Novel commercially available software has enabled registration of both CT and MRI images to rapidly fuse with X-ray fluoroscopic imaging. We describe our initial experience performing cardiac catheterisations with the guidance of 3D imaging overlay using the VesselNavigator system (Philips Healthcare, Best, NL). A total of 33 patients with CHD were included in our study. Demographic, advanced imaging, and catheterisation data were collected between 1 December, 2016 and 31 January, 2019. We report successful use of this technology in both diagnostic and interventional cases such as placing stents and percutaneous valves, performing angioplasties, occlusion of collaterals, and guidance for lymphatic interventions. In addition, radiation exposure was markedly decreased when comparing our 10–15-year-old coarctation of the aorta stent angioplasty cohort to cases without the use of overlay technology and the most recently published national radiation dose benchmarks. No complications were encountered due to the application of overlay technology. 3D CT or MRI overlay for CHD intervention with rapid registration is feasible and aids decisions regarding access and planned angiographic angles. Operators found intraprocedural overlay fusion registration using placed vessel guidewires to be more accurate than attempts using bony structures.

Keywords

Interventional cardiologycardiac CTcardiac MRI3D guidancestentingVesselNavigator
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 5 , May 2020 , pp. 656 - 662
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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