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Proceedings Paper

A planning system for transapical aortic valve implantation
Author(s): Michael Gessat; Denis R. Merk; Volkmar Falk; Thomas Walther; Stefan Jacobs; Alois Nöttling; Oliver Burgert
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Paper 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.

Paper Details

Date Published: 13 March 2009
PDF: 12 pages
Proc. SPIE 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling, 72611E (13 March 2009); doi: 10.1117/12.810270
Show Author Affiliations
Michael Gessat, Innovation Ctr. Computer Assisted Surgery (Germany)
Denis R. Merk, Innovation Ctr. Computer Assisted Surgery (Germany)
Heart Ctr. Leipzig (Germany)
Volkmar Falk, Heart Ctr. Leipzig (Germany)
Thomas Walther, Heart Ctr. Leipzig (Germany)
Stefan Jacobs, Heart Ctr. Leipzig (Germany)
Alois Nöttling, Siemens AG (Germany)
Oliver Burgert, Innovation Ctr. Computer Assisted Surgery (Germany)

Published in SPIE Proceedings Vol. 7261:
Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling
Michael I. Miga; Kenneth H. Wong, Editor(s)

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