Abstract
Results from an international multi-center prospective registry of cardiac catheterizations and percutaneous cardiac interventions guided with three-dimensional imaging
- Department of Pediatric Cardiology, University Children’s Hospital, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
- Department of Pediatric Cardiology, University of Colorado, The Heart Institute, Children’s Hospital Colorado, Aurora, Colorado, United States
- Department of Pediatrics, Sejong General Hospital, Bucheon, Republic of Korea
- Department of Pediatric Cardiology/Congenital Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico
- Deutsches Herzzentrum der Charité, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
- Center for Congenital Heart Disease/Department of Pediatric Cardiology Heart and Diabetes Centre NRW, University Hospital oft he Ruhr University Bochum, Bad Oeynhausen, Germany
Introduction
Developments in fusion imaging (FI) software have facilitated easy use of three-dimensional (3D) roadmaps based on preregistered computed tomography (CT) or magnetic resonance imaging (MRI) datasets for guidance of cardiac catheterizations.
Aim
The aim of this study was to report the initial results from the first international prospective registry of cardiac catheterizations guided with fusion of CT and MRI datasets.
Material and methods
A multi-center prospective registry was set up to evaluate fusion of fluoroscopic two-dimensional (2D) images and the CT- or MRI-derived 3D roadmaps for guidance of cardiac catheterizations in congenital heart disease.
Results
Fusion imaging was applied in 205 patients for guidance (n = 182) or planning (n = 23) of cardiac catheterization. Successful fusion of CT or MRI images was achieved in all cases. In 176 (96.7%) patients, 2D–3D registration was performed. In the remaining 6 patients, 3D–3D registration was utilized. Accurate initial 3D roadmap alignment was achieved in 142 (78%) patients. Seventeen (9.3%) patients required intra-procedural readjustment of the 3D roadmap due to distortion of the anatomy. Interventional procedures were performed in 137 (75.3%) patients. In 37 (20.3%) patients, catheterization was performed using only 3D guidance without additional angiography. Overall, 3D guidance with FI was deemed at least useful in 98.3% of patients and not useful or misleading in 3 (1.7%) patients.
Conclusions
Direct 2D–3D registration of pre-catheterization CT or MRI is a safe and effective method of guidance of cardiac catheterization in selected congenital heart disease cases. In selected patients, FI facilitates percutaneous interventions without contrast angiography.
>Keywords
cardiac catheterization, fusion imaging, image guidance, computed tomography, magnetic resonance imaging
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