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Image-Guiding Software Advances Heart Valve, Cath Lab Procedures

An increasing number of patients at Miami Cardiac & Vascular Institute [1] with structural heart disease can be treated with the latest trans-catheter (non-surgical) techniques, thanks in part to the growing number of suitable devices.

Now new technology, Philips’ EchoNavigator, addresses the growing need for both X-ray imaging and 3D cardiac ultrasound imaging (also known as echocardiography, or “echo” for short) during structural heart disease procedures.

During these procedures, X-rays and cardiac ultrasounds are used simultaneously to guide treatment. However, the EchoNavigator takes the two imaging platforms and fuses them onto the same screen simultaneously. This helps guide device placement more efficiently during structural heart disease procedures.

“The software essentially ‘fuses’ the two screened images so that both sides of the procedure — the surgeon doing the procedure and the person doing the ultrasound — are following in real-time,” explains Elliott Elias, M.D. [2], a cardiologist with a focus on interventional echocardiography.

The increasing number of complex procedures being performed that involve such “fusion” software include transcatheter aortic valve replacements (TAVR); mitral valve repairs, and complex coronary interventions.

“Philips Healthcare has been a partner of the Miami Cardiac & Vascular Institute for many years on the echo ultrasound side, as well on the Image Guided Therapy side,” said Carol Melvin, chief operating officer for the Institute. “We are pleased at how they fused the two technologies together to create a better way to serve our cardiac patients.”

In many procedures having to do with the diseased heart’s valves , (3D) transesophageal echocardiography (TEE) imaging provides a critical look into the soft tissues, as well as data on the heart’s functioning and blood flow. At the same time, X-ray imaging provides interventionalists with their primary visual platform for the placement of catheters or other devices being used to repair or replace critical components of the heart’s structure.

Previously, these images have been represented differently to surgeons and interventionalists involved in the procedure, so valuable time and effort are often spent on aligning the two representations — those of the ultrasound and the X-rays. EchoNavigator essentially eliminates that time and effort.

The repairs or replacement of diseased heart valves take place at the Institute’s Cardiac Catheterization Lab, or Cath Lab, which also uses diagnostic imaging for patients who potentially need treatment for narrow or blocked blood vessels.

“Normally, the way that the Cath Lab room is set up — one side you have the person that’s doing the procedure and then on the other side it’s that’s doing the imaging,” says Dr. Elias. “But the person that’s doing the procedure looks at both screens — the ultrasound and the X-ray. So, both images being in sync together is critical and this software ensures that and enables the procedure to be more efficient.”

Here are some of the key benefits of using EchoNavigator, say cardiac surgeons and interventional cardiologists: