Medical Viewing System for TAVR Cusp Nadir Alignment
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Solution Overview
Problem
Current medical imaging systems face challenges in accurately aligning markers with the nadirs of the aortic valve cusps during transcatheter aortic valve replacement procedures, requiring multiple aortograms to determine the optimal viewing angle, which increases radiation dose and contrast agent use.
Innovation Solution
A medical viewing system that combines live X-ray and echocardiography images using a processing unit to register and localize characteristic features, automatically adjusting the X-ray image acquisition device to an optimal viewing angle where markers align equidistantly, reducing the need for multiple aortograms and enhancing precision.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If multiple aortograms are acquired to determine the optimal viewing angle, then the accuracy of marker alignment with cusp nadirs is improved, but the radiation dose and contrast agent use increase
Solution Approach 1:
The patent introduces echocardiography imaging as an intermediary modality to locate cusp nadirs. The echocardiography probe provides clear visualization of the three aortic valve cusps and their nadirs, which are difficult to locate in X-ray images alone. By using echocardiography as a mediator, the system can accurately identify nadir positions without requiring multiple X-ray aortograms, thus reducing radiation exposure while maintaining alignment accuracy.
Solution Approach 2:
The patent replaces the trial-and-error mechanical approach of acquiring multiple aortograms with an automated image processing system. The processing unit automatically detects cusp nadirs in echocardiography images, calculates the optimal viewing angle based on geometric relationships, and guides the C-arm positioning. This substitution of manual iterative imaging with automated computational methods eliminates the need for repeated radiation exposure.
2Measurement precision
If multiple aortograms are acquired to determine the optimal viewing angle, then the accuracy of marker alignment with cusp nadirs is improved, but the contrast agent use increases
Solution Approach 1:
The patent uses echocardiography imaging as an intermediary that does not require contrast agents. Echocardiography provides real-time visualization of cardiac structures using ultrasound waves, eliminating the need for iodine-based contrast agents required by X-ray aortography. By obtaining cusp nadir positions from echocardiography images instead of multiple aortograms, the system reduces contrast agent consumption while maintaining alignment accuracy.
3Ease of operation
If manual marker placement on TEE images is used, then the system can display approximate cusp positions on X-ray images, but the alignment accuracy with cusp nadirs deteriorates
Solution Approach 1:
The patent implements an automated system where the processing unit performs marker placement and alignment without manual intervention. The system automatically detects cusp nadirs in echocardiography images, calculates their positions, and places markers at the precise nadir locations. This self-service automation eliminates the imprecision of manual marker placement while maintaining operational efficiency, as the system performs the complex alignment task autonomously based on image analysis.
Solution Approach 2:
The patent replaces the manual mechanical process of placing markers on TEE images with an automated image processing and pattern recognition system. The processing unit analyzes echocardiography images to automatically identify cusp nadirs and calculate their precise coordinates, then establishes markers at these locations. This substitution of manual placement with automated computational methods significantly improves alignment accuracy while maintaining ease of operation through automation.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This system simplifies the clinical workflow by precisely determining the optimal viewing angle with reduced radiation and contrast agent use, improving the accuracy and efficiency of valve deployment procedures.
Implementation Method 1
an X-ray image acquisition device for providing live X-ray images from a variable viewing angle
Implementation Method 2
an echocardiography imaging device having an ultrasonic probe for providing live ultrasound images
Data Source
AI summary
An medical viewing system (10) adapted for acquiring a first set of X-ray fluoroscopy images of an ultrasonic probe (40) of an echocardiography imaging device at two different viewing angles, wherein a processing unit (30) of the system is adapted for registering live echocardiography and live X-ray images based on the first set of X-ray fluoroscopy images, localizing cusp nadirs positions of a set of characteristic features (42, 44, 46) in the X-ray subsequent frames, establishing a set of markers to match the localized positions of the cusp nadirs characteristic features (42, 44, 46), and determining an optimal viewing angle of the X-ray image acquisition device (12), in which the markers of the second set of markers lie on a single line and are equidistant from each other in the X-ray field of view. This enables a precise alignment of the X-ray imaging device, especially for TAVR procedures.