Current and Future Aspects of Multimodal Imaging, Diagnostic, and Treatment Strategies in Bicuspid Aortic Valve and Associated Aortopathies.

Bicuspid aortic valve (BAV) is the most frequent congenital cardiac abnormality leading to premature aortic valve apparatus dysfunction and is often associated with aortopathy. Therefore, current guidelines recommend a surgical aortic valve replacement (SAVR), even if many patients are deemed inoperable owing to their comorbidities and require alternatives such as transcatheter aortic valve replacement (TAVR). However, BAV variations remain challenging for procedural success.

Echocardiographic and Fluoroscopic Fusion Imaging for Procedural Guidance: An Overview and Early Clinical Experience.

There has been significant growth in the volume and complexity of percutaneous structural heart procedures in the past decade. Increasing procedural complexity and accompanying reliance on multimodality imaging have fueled the development of fusion imaging to facilitate procedural guidance. The first clinically available system capable of echocardiographic and fluoroscopic fusion for real-time guidance of structural heart procedures was approved by the US Food and Drug Administration in 2012.

Novel System for Real-Time Integration of 3-D Echocardiography and Fluoroscopy for Image-Guided Cardiac Interventions: Preclinical Validation and Clinical Feasibility Evaluation.

Real-time imaging is required to guide minimally invasive catheter-based cardiac interventions. While transesophageal echocardiography allows for high-quality visualization of cardiac anatomy, X-ray fluoroscopy provides excellent visualization of devices. We have developed a novel image fusion system that allows real-time integration of 3-D echocardiography and the X-ray fluoroscopy.

Extended-field-of-view three-dimensional transesophageal echocardiography using image-based X-ray probe tracking.

The use of ultrasound imaging for guidance of cardiac interventional procedures is limited by the small field of view of the ultrasound volume. A larger view can be created by image-based registration of several partially overlapping volumes, but automatic registration is likely to fail unless the registration is initialized close to the volumes' correct alignment. In this article, we use X-ray images to track a transesophageal ultrasound probe and thereby provide initial position information for the registration of the ultrasound volumes.

Coronary sinus anatomy by computerized tomography, overlaid on live fluoroscopy can be successfully used to guide left ventricular lead implantation: a feasibility study.

Objective: This study aims to optimize coronary sinus (CS) computerized tomography (CT) imaging and evaluate its utility for preprocedural planning and intraoperative guidance by overlay of 3D reconstructed CS images on live fluoroscopy.

Background: Optimal CS lead placement for cardiac resynchronization therapy (CRT) remains challenging. Preprocedural knowledge of CS anatomy can significantly affect procedural outcome.

First experience with rotational angiography of the right ventricle to guide ventricular tachycardia ablation.

Background: Rotational angiography with three-dimensional reconstruction (3DRA) is a new imaging tool recently introduced to guide mapping and ablation of the left atrium.

Objective: The purpose of this study was to determine the utility of 3DRA for imaging the ventricles and guiding ventricular tachycardia (VT) ablation.

Methods: Using the Philips Allura Xper FD10 system, 3DRA was performed in eight patients referred for right ventricular outflow tract (RVOT) VT ablation.

Influence of hydration and mechanical characterization of carious primary dentine using an ultra-micro indentation system (UMIS).

The conditions under which mechanical properties of dentine are tested influence the values recorded. The aims of this study were to examine the effect of hydration on the mechanical properties of primary carious dentine and to provide information on changes in hardness and modulus of elasticity change caused by the demineralizing caries process in dentine. Three primary molar teeth with untreated carious dentine were prepared for nano-indentation tests under both wet and dry conditions.