Method of imaging for heart valve implant procedure

• US 8,177,835 B2
• Filed: 08/21/2009
• Issued: 05/15/2012
• Est. Priority Date: 08/21/2009
• Status: Expired due to Fees

• Current Assignee: Siemens AG
• Original Assignee: Siemens AG
• Inventors: Noettling, Alois, Boese, Jan, John, Matthias, Falk, Volkmar, Walther, Thomas
• Primary Examiner(s): WOO, JULIAN W
• Application Number:
  US12/545,435
• Publication Number:
  US 20110046725A1
• Time in Patent Office: 998 Days
• Field of Search: 606/130, 600/415, 600/416, 600/419, 600/420, 623/2.1, 623/2.11
• US Class Current: 623/2.1
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• CPC Class Codes: A61F 2/24 Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body

Abstract

A method as a workflow for imaging for a heart valve implant procedure includes positioning the patient and an articulated imaging apparatus relative to one another, inducing rapid ventricular pacing in the patient, and imaging a region of the patient'"'"'s heart to obtain image date for a three-dimensional image. The three-dimensional data is used to construct a three-dimensional image of the region of the patient'"'"'s heart an the three-dimensional image is displayed for use in the implanting of the replacement heart valve. Optional steps may include obtaining a real time two-dimensional image of the patient'"'"'s heart and superimposing the real time two-dimensional image with the constructed three dimensional image. The replacement valve is moved into position in the patient'"'"'s heart during rapid ventricular pacing and breath hold using the superimposed two-dimensional and three-dimensional image information.

Claims

1. A method of imaging a patient for a heart valve implant procedure, comprising the steps of:

positioning the patient relative to an articulated imaging apparatus to provide isocentric positioning of an aortic root of the patient'"'"'s heart relative to the imaging apparatus;

inducing rapid ventricular pacing in the patient;

injecting a contrast agent into the patient during the rapid ventricular pacing state;

imaging a region of the aortic root using the articulated imaging apparatus to obtain image data for constructing a three-dimensional image; and

constructing a three dimensional image using data from the imaging step.

2. A method as claimed in claim 1, further comprising the step of:

segmenting image data obtained in said imaging step.

3. A method as claimed in claim 2, wherein said segmenting step is performed automatically.

4. A method as claimed in claim 1, further comprising the step of:

measuring anatomical parameters from the image data obtained in said imaging step.

5. A method as claimed in claim 4, wherein said measuring step is performed automatically.

6. A method as claimed in claim 1, further comprising the steps of:

imaging the patient using an x-ray imaging apparatus to obtain two-dimensional x-ray image data of a region of the patient'"'"'s heart;

superimposing the two-dimensional x-ray image data in real time with the three-dimensional image obtained in the imaging step to obtain three-dimensional image data;

displaying the superimposed two-dimensional and three-dimensional images on a display apparatus;

inducing rapid ventricular pacing in the patient during the imaging to obtain two-dimensional image data so as to cause the patient'"'"'s heart to be in a substantially identical heart phase state as during the imaging to obtain the three-dimensional image data;

introducing a replacement aortic valve into position in the patient'"'"'s heart during the rapid ventricular pacing using the displayed superimposed real time two-dimensional x-ray image and three-dimensional image data.

7. A method as claimed in claim 1, further comprising the steps of:

generating a multi-slice computed tomography image from the three-dimensional image data;

imaging the patient using an x-ray imaging apparatus to obtain two-dimensional x-ray image data of a region of the patient'"'"'s heart;

superimposing the two-dimensional x-ray image data in real time with the multi-slice computed tomography image; and

displaying the superimposed two-dimensional and multi-slice computed tomography images on a display apparatus.

8. A method as claimed in claim 1, further comprising the steps of:

segmenting structures of the patient within the three-dimensional image; and

fusing the structures with a further image modality.

9. A method as claimed in claim 1, wherein said further image modality is selected from the image modalities consisting of a magnetic resonance imaging apparatus, a computed tomography imaging apparatus, and an ultrasound imaging apparatus.

10. A method as claimed in claim 1, wherein said step of injecting the contrast agent includes injecting the contrast agent into or close to the aortic root.

11. A method as claimed in claim 1, further comprising the step of:

adjusting a projection direction of an x-ray imaging device and a visualization direction of pre-implant images to correspond with one another.

12. A method as claimed in claim 11, wherein said step of adjusting includes the steps of:

positioning the projection direction of the x-ray imaging device, and

automatically adjusting the visualization direction of the pre-implant images on a display to correspond to the projection direction of the x-ray imaging device.

13. A method as claimed in claim 11, wherein said step of adjusting includes the steps of:

positioning the visualization direction of the pre-implant images; and

automatically adjusting the projection direction of the x-ray imaging device to correspond to the visualization direction.

14. A method as claimed in claim 1, further comprising the step of:

inducing a breath-hold by one of instructing the patient to breath-hold or stopping a ventilator if the patient is anaesthetized.

15. A method of imaging a patient for a heart valve implant procedure, comprising the steps of:

positioning the patient relative to an imaging apparatus to provide isocentric positioning of a predetermined structure of the patient'"'"'s heart relative to the imaging apparatus;

inducing rapid ventricular pacing in the patient and instruct the patient to breath-hold;

injecting a contrast agent into a portion of the patient'"'"'s heart during the rapid ventricular pacing state;

imaging a region of the patient'"'"'s heart using the imaging apparatus to obtain image data for constructing a three-dimensional image;

constructing a three dimensional image using data from the imaging step; and

using the constructed three dimensional image during implant of a heart valve in the patient'"'"'s heart.