title: The effect of X-ray beam distortion on the Edwards Sapien XT(™) trans-catheter aortic valve replacement prosthesis.
abstract: Profiling the Aortic root perpendicular to the fluoroscopic image plane will achieve a more successful implant position for trans-catheter aortic valve replacement (TAVR). This study aimed to investigate whether the divergent nature of the X-ray beam from the C-arm altered the appearance of the TAVR device.
  
  
  
  Under bench-top testing, a 23, 26 and 29 mm Edwards Sapien XT valve was positioned coaxially at the bottom of a fluoroscopic image utilising 22 and 32 cm fields of view (FOV). The table was then moved so that the valve was positioned at the top of the image. The valve's appearance was scored using a previously published three tier classification tool (excellent, satisfactory and poor) and quantified with measurements. The number of degrees of C-arm rotation that were required to bring the valve back to a coaxial appearance was recorded.
  
  
  
  When using the 32 cm FOV, the valve's appearance changes from excellent to satisfactory. When a 22 cm FOV was used, the change is less marked. More C-arm rotation is required to bring the appearance back to coaxial with the 32 cm FOV.
  
  
  
  Not maintaining the valve in the centre of the image can distort the valves appearance. This has the potential to affect the final implantation depth.
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia; University of Queensland St Lucia, Brisbane Queensland Australia; Medical Imaging Department The Prince Charles Hospital Chermside Queensland Australia.
authors: James A
authors: JA
authors: Crowhurst
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia.
authors: Karl K
authors: KK
authors: Poon
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia; University of Queensland St Lucia, Brisbane Queensland Australia.
authors: Dale
authors: D
authors: Murdoch
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia.
authors: Alexander
authors: A
authors: Incani
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia; University of Queensland St Lucia, Brisbane Queensland Australia.
authors: Owen C
authors: OC
authors: Raffel
authors: Medical Imaging Department The Prince Charles Hospital Chermside Queensland Australia.
authors: Annelise
authors: A
authors: Liddicoat
authors: Heart and Lung Institute The Prince Charles Hospital Chermside Queensland Australia; University of Queensland St Lucia, Brisbane Queensland Australia.
authors: Darren
authors: D
authors: Walters
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D011859:Radiography / Q000379:methods / Q000592:standards; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000592:standards; D014965:X-Rays
keywords: C‐arm rotation; TAVR; X‐ray; distortion; fluoroscopy; percutaneous