Author + information
- Stacey D. Clegg, MD∗,
- S. James Chen, PhD†,
- Niels Nijhof, MSc‡,
- Michael S. Kim, MD†,
- Ernesto E. Salcedo, MD†,
- Robert A. Quaife, MD†,
- John C. Messenger, MD†,
- John Bracken, PhD§ and
- John D. Carroll, MD†∗ ()
- ∗University of New Mexico Health Science Center, Albuquerque, New Mexico
- †University of Colorado Hospital, University of Colorado, Denver, Aurora, Colorado
- ‡Philips Healthcare, Best, the Netherlands
- §Philips Research, Best, the Netherlands
- ↵∗Reprint requests and correspondence:
Dr. John D. Carroll, University of Colorado Anschutz Medical Campus, Mail Stop B132, 12401 East 17th Avenue, Aurora, Colorado 80045.
Real-time, 3-dimensional transesophageal echocardiography (RT 3D TEE) is now used routinely in conjunction with x-ray fluoroscopy to guide percutaneous structural heart disease (SHD) interventions. Unlike fluoroscopy, RT 3D TEE provides excellent detail of 3D anatomy and soft tissue structures, and provides “live” intraprocedure guidance. A novel 3D echo-x-ray navigation system that successfully integrates TEE imaging and fluoroscopic images, on the basis of a 2D to 3D image registration technique, has been developed and is now commercially available.
Registration of RT 3D TEE and fluoroscopy provides real-time simultaneous interactive imaging in 2 modalities that are specifically used for the guidance of SHD interventions. This iPix imaging series describes our initial experiences during the development of this navigation system, including a library of case examples with illustrative images. Several representative examples are presented in Figures 1 to 4⇓⇓⇓⇓. An ASD closure using the integrated features of the system is demonstrated in Online Video 1. Perceived benefits include enhanced anatomic understanding and improved delivery system navigation and improved multidisciplinary team communication.
For an accompanying video and legend, please see the online version of this article.
This study was supported with a research grant to the University of Colorado Denver from Philips Healthcare.
Drs. Carroll and Salcedo are consultants for Philips Healthcare.
Drs. Chen and Carroll received royalties from Philips Healthcare for patented technology unrelated to the technology described in this paper. Dr. Carroll has received a research grant from Philips Healthcare. Dr. Kim has received research funding from Philips Healthcare. Dr. Quaife has received a research grant from Philips Medical. Dr. Bracken is a full-time employee of Philips Research; and is a full-time imaging scientist stationed at the University of Colorado Hospital. Mr. Nijhof is a full-time employee of Philips Healthcare in Best, the Netherlands who was responsible for prototypes and worked with the University of Colorado team during the technologies development and first clinical applications. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- American College of Cardiology Foundation