3-D in angiography: New imaging software from Siemens simplifies workflow for minimally invasive heart valve implantation

The software selects anatomical landmarks as the coronary ostia, for instance, and overlays the 3D image with two-dimensional images acquired during live fluoroscopy. That way, the physician obtains real-time, three-dimensional guidance in the patient’s body while navigating the new valve to its intended location.

During the minimally invasive TAVI (transcatheter aortic valve implantation) intervention, an artificial aortic valve is inserted via the femoral artery or through the apex of the heart. A new image processing software from provides the physician automated 3D guidance for the procedure: Syngo Aortic ValveGuide segments the aortic root in three-dimensional mode from Syngo DynaCT Cardiac images. With the aid of anatomical landmarks in the 3D representation of the vessel, Syngo Aortic ValveGuide calculates the exact perpendicular view on the aortic root. The C-arm adjusts to the corresponding angulations for live fluoroscopy.

That way, it provides the proper perspective that the physician requires to exactly position the new valve. Consequently, as soon as the software overlays the 3D image of the aorta with the two-dimensional live fluoroscopy, the cardiologist in the cath lab or, respectively, the heart surgeon in the hybrid room, can start the intervention. Since Syngo Aortic ValveGuide only requires a short fluoroscopy time prior to the procedure, the patient's exposure to radiation and contrast agent can be reduced considerably.

The Heart Center in Leipzig, one of the leading facilities in Germany to perform TAVI-procedures, had previously performed several of these interventions with the Syngo DynaCT Cardiac from Siemens. This software processes CT-like images of the heart from images acquired with the angiography system. However, to overlay live fluoroscopy images with these 3D images and find the correct angulation for the C-arm, the physician had to leave the sterile operating area and perform manual angulation calculations at a workstation – or make medical staff available solely for this purpose. “With Syngo Aortic ValveGuide, we can now find the optimal angulation with a perpendicular view on the aortic root easier and faster than before, because the software automates so many work steps,” says Dr. Jörg Kempfert, heart surgeon at the Heart Center Leipzig.

The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 48,000 employees worldwide and operates around the world. In fiscal year 2009 (to September 30), the Sector posted revenue of 11.9 billion euros and profit of around 1.5 billion euros.

The product mentioned herein is not commercially available. Due to regulatory reasons its future availability cannot be guaranteed.

The outcomes achieved by the Siemens customers described herein were achieved in the customer's unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that others will achieve the same results. The Heart Center of the University Leipzig has a cooperation contract with Siemens Healthcare.