Balloon Valvuloplasty to Predict X-ray Projection Angles that are Perpendicular to Cardiovascular Structures: A TAVI Patient Feasibility Study Journal Article


Authors: Fetterly, K.; Greason, K; Mathew, V
Article Title: Balloon Valvuloplasty to Predict X-ray Projection Angles that are Perpendicular to Cardiovascular Structures: A TAVI Patient Feasibility Study
Abstract: OBJECTIVES: The purpose of this work is to describe methods to measure the 3D angular orientation of cardiovascular structures based on a planar image of a valvuloplasty balloon. These methods facilitate X-ray beam alignment with respect to the anatomy of interest. BACKGROUND: X-ray beam projections which are perpendicular to the long axis of cardiovascular structures are required to support interventional procedures, including transcatheter aortic valve implant (TAVI). METHODS: During the TAVI procedure, the 3D angular orientation of the LVOT of 10 patients was measured from a single planar image of an aortic valvuloplasty balloon and the continuous range of X-ray projection angles which are aligned with the aortic valve plane were calculated (research method). Misalignment of the X-ray beam and TAVI valve frame was measured from images of the deployed valve. The accuracy of the research method was compared to clinical standard method to determine appropriate X-ray projection angles, which utilized CT and aortography. RESULTS: Using the clinical standard method, the median misalignment of the X-ray beam and TAVI valve frame was 8.6 degrees (range 2.6 degrees to 21 degrees ). Misalignment was reduced to 2.5 degrees (range 0 degrees to 10 degrees ) using the research method. CONCLUSIONS: The 3D angular orientation of cardiovascular structures can be measured accurately from a single X-ray projection image of a known cardiovascular device contained within the anatomy of interest. For TAVI procedures, improved X-ray beam alignment may help facilitate procedural success. (c) 2016 Wiley Periodicals, Inc.
Journal Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography Interventions
ISSN: 1522-726X; 1522-1946
Publisher: Wiley Periodicals, Inc  
Journal Place: United States
Date Published: 2016
Language: eng
DOI/URL:
Notes: LR: 20161130; CI: (c) 2016; JID: 100884139; OTO: NOTNLM; 2016/06/23 [received]; 2016/11/08 [accepted]; aheadofprint