Rapid pacing rotational angiography with three-dimensional  reconstruction: use and benefits in structural heart disease  interventions.
OBJECTIVE
High quality three-dimensional imaging is one of the cornerstones in structural heart disease interventions. Current mainstream technology to acquire three-dimensional imaging utilises computed tomography or magnetic resonance imaging. Incorporation of these data with conventional angiographic images may not be sufficient. We describe a new imaging technique consisting of rotational angiography combined with rapid pacing to obtain real-time, high-quality, three-dimensional images in the catheterisation laboratory.


RESULTS
Rotational angiography is performed with breath holding and rapid pacing on a large format digital flat-panel angiographic system. During a 200 degrees rotation, 150 angiographic images are acquired in five seconds and automatically reconstructed in less than 30 seconds. This imaging technique was used in six patients (mean age 32 +/- 10 years) to guide structural heart disease interventions. No complications were associated with rapid pacing. This imaging technique allowed acquisition of high-quality, three-dimensional images with a low volume of contrast media. Volume renderings helped appreciation of the lesions and optimisation of the working views. Multiplanar visualisation allowed true orthogonal measurements of vascular diameter during the procedures.


CONCLUSIONS
The advantages of this imaging technique include rapid image acquisition and precise imaging of complex structures using low volume of contrast media.
Noble
Stéphane
S
Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Canada.
Miró
Joaquim
J
Yong
Gerald
G
Bonan
Raoul
R
Tardif
Jean-Claude
JC
Ibrahim
Réda
R
D000328:Adult; D006328:Cardiac Catheterization / Q000295:instrumentation; D002304:Cardiac Pacing, Artificial; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D055815:Young Adult
D003287:Contrast Media