title: Phantom study of an ultrasound guidance system for transcatheter aortic valve implantation.
abstract: A guidance system using transesophageal echocardiography and magnetic tracking is presented which avoids the use of nephrotoxic contrast agents and ionizing radiation required for traditional fluoroscopically guided procedures. The aortic valve is identified in tracked biplane transesophageal echocardiography and used to guide stent deployment in a mixed reality environment. Additionally, a transapical delivery tool with intracardiac echocardiography capable of monitoring stent deployment was created. This system resulted in a deployment depth error of 3.4mm in a phantom. This was further improved to 2.3mm with the custom-made delivery tool. In comparison, the variability in deployment depth for traditional fluoroscopic guidance was estimated at 3.4mm.
authors.affiliation: Robarts Research Institute, Western University, London, Ontario, Canada. Electronic address: jmcleod@robarts.ca.
authors.forename: A Jonathan
authors.initials: AJ
authors.lastname: McLeod
authors.affiliation: Robarts Research Institute, Western University, London, Ontario, Canada; Department of Cardiac Surgery, London Health Science Centre, London, Ontario, Canada.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Currie
authors.affiliation: Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: John T
authors.initials: JT
authors.lastname: Moore
authors.affiliation: Department of Anesthesiology, London Health Science Centre, London, Ontario, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bainbridge
authors.affiliation: Department of Cardiac Surgery, London Health Science Centre, London, Ontario, Canada.
authors.forename: Bob B
authors.initials: BB
authors.lastname: Kiaii
authors.affiliation: Department of Cardiac Surgery, London Health Science Centre, London, Ontario, Canada.
authors.forename: Michael W A
authors.initials: MW
authors.lastname: Chu
authors.affiliation: Robarts Research Institute, Western University, London, Ontario, Canada.
authors.forename: Terry M
authors.initials: TM
authors.lastname: Peters
mesh_terms: D001021:Aortic Valve; D017548:Echocardiography, Transesophageal; D005471:Fluoroscopy; D006801:Humans; D015607:Stents; D065467:Transcatheter Aortic Valve Replacement
keywords: Echocardiography; Fluoroscopy; Image guidance; Mixed reality; Transapical; Transcatheter aortic valve implantation