Syngo aortic valve_guide_customer_presentation_neu_132447179_1

© Siemens AG 2013 All rights reserved. H IM AX 11/12-193 Answers for life.

syngo Aortic ValveGuide

Enhanced workflow and accuracy for valve

positioning

Clinical applications

Page 2 Siemens Healthcare, Angiography & Interventional X-Ray Systems

© Siemens AG 2013 All rights reserved. H IM AX 11/12-193

Three essential benefits for valve implantations

Automated workflow

through fully automatic aortic root segmentation, indication of anatomical landmarks

and synchronization of C-arm angulation to perpendicular view – in seconds

Improved guidance

through landmarks and overlay of segmented 3D structures onto live 2D fluoroscopy

Dose and contrast medium savings

through 3D guidance based on syngo DynaCT Cardiac acquisition and ideal

automatic C-arm positioning without additional fluoroscopy



“We've been using syngo DynaCT for a long time now. It allows us

to evaluate the anatomy of the aortic root and the position of the

coronary ostia. The overlay of the intra-procedural 3D image over

live fluoroscopy gives us an additional level of confidence for the

valve implantation. Since October 2011 we've now been using

syngo Aortic ValveGuide. The automated workflow makes the

procedure easier and the indication of a perpendicular view plane

helps to make it even safer.”

The statements by Siemens’ customers described herein are based on results that 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 other customers will achieve the same results.

William W. O’Neill, University of Miami, USA

Customer testimonial I



“syngo Aortic ValveGuide makes it so quick and easy for us to find

the optimal perpendicular view on the annulus. The software does

everything automated. Based on the DynaCT Cardiac images it

derives the optimal plane for the valve implantation and then we

can synchronize the

C-arm projection with this view without giving additional root

shots.”

Dr. Jörg Kempfert, Heart Center Leipzig, Germany

Customer testimonial II

The statements by Siemens’ customers described herein are based on results that 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 other customers will achieve the same results.



Fluoroscopic guidance for valve deployment

The gold standard of the past

Images courtesy of Heart Center Leipzig

Valve deployment with 2D guidance

Transfemoral approach




A new level of valve positioning convenience



2D images cannot deliver sufficiently precise information for angulation and

placement

• Perpendicular projection required to ensure proper valve deployment while minimizing risk

of aortic regurgitation

• Correct placement crucial to avoid blockage of coronary arteries or valve dislocation

• Anatomical information in 3D needed for implantation of non-rotationally symmetric valves

Challenges when implanting transcatheter valves




A new level of valve positioning convenience

• Efficiency

A single syngo DynaCT Cardiac acquisition is sufficient for finding an perpendicular view

to implant the valve and to understand the anatomy of the coronary ostiae

• Confidence

Implantation height in relation to aortic root present during whole procedure ensuring correct

valve placement

• Ready for future valve generations

3D imaging provides anatomical information (e.g. valve cusps, commissure lines)

required for implantation of anatomical valves

That meansThat means




Efficient guidance for valve implantations

• No user interaction needed – no need to leave sterile area

• Reconstruction, segmentation and landmarks in less than 30 seconds

• Potential contrast media and dose savings when compared to conventional CT or 2D imaging

Automated workflow

Rotational angiography syngo DynaCT Cardiac

Reconstruction


Segmentation




Segmentation and landmark detection

• recognizes and represents the aortic root

• detects and indicates coronary ostiae and

lowest cusp points of aortic valve (nadir points)

• reconstructs commissure lines of aortic

valve (WIP)

• selects perpendicular view plane

The software automatically…

Image courtesy of Herz- und Kreislaufzentrum Rotenburg a.d. Fulda




Perpendicular new plane

Optimum angulation – perpendicular to annulus

A circle parallel to the plane spanned by the three lowest points of the cusps is derived

The circle is transformed into a straight line when the three lowest cusp points are aligned, providing optimal perpendicular angulation





Contour view – focus on the essentials

• show only the essential landmarks needed for

prosthesis positioning and deployment steps

• allow for display of additional fluoroscopic

information

Switch to contour mode during 2D/3D overlay to…

Image courtesy of Kerckhoff-Klinik, Bad Nauheim




Overlay of 3D and live fluoro

• facilitates orientation during valve positioning

• guides valve deployment

• overlay is dynamically adapted to C-arm rotations

and table movements

Dynamic overlay with syngo iPilot

Image courtesy of Kerckhoff-Klinik, Bad Nauheim




Key features

• Automatic intraprocedural segmentation and

display of aortic root anatomy in 3D based on

syngo DynaCT

• Anatomic landmarks to guide the valve

deployment, e.g. coronary ostia, nadir points

• Indication of perpendicular view to adjust the

C-arm projection for confidence in valve positioning

• Contour view for exact positioning by showing the

device in the aortic root and the landmarks in live

fluoro overlay

Better planning and orientation during valve deployment

Image courtesy of Herz- und Kreislaufzentrum Rotenburg a.d. Fulda and Kerckhoff-Klinik Bad Nauheim




Key take-aways

• Improved guidance and increased procedural safety through overlay of 3D information and anatomical landmarks

• Speed and efficiency with automated workflow from rotational angiography to segmentation and 3D overlay in less than 25 seconds

• Possible contrast savings thanks to 3D guidance and adjustment of C- arm to perpendicular view



Workflow during trans-apical implantation of Edwards Sapien valve




Implantation of Medtronic Corevalve

Image courtesy of Herz- und Kreislaufzentrum Rotenburg a.d. Fulda



Angiography & Interventional X-Ray Systems.Answers for life.

On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this presentation are available through the Siemens sales

organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice.

Syngo aortic valve_guide_customer_presentation_neu_132447179_1

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