Variations in Right Ventricular Outflow Tract Morphology Following Repair of Congenital Heart Disease: Implications for Percutaneous Pulmonary Valve Implantation

Schievano, Silvia; Coats, Louise; Migliavacca, Francesco; Norman, Wendy; Frigiola, Alessandra; Deanfield, John; Bonhoeffer, Philipp; Taylor, Andrew M.

doi:10.1080/10976640601187596

Cited by 198 publications

(128 citation statements)

References 17 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…The morphology of the pulmonary trunk is a major determinant of suitability for PPVI [5]. Intervention in unsuitable patients exposes patients to unnecessary invasive catherization.…”

Section: Results On Model Based Patient Selection Suitable For Ppvimentioning

confidence: 99%

“…Schievano et.al. [5] proposed the classification of various morphologies in five groups: pyramidal shape (type I), constant diameter (type II), inverted pyramidal shape (type III), wide centrally but narrowed proximally and distally (type IV), and narrowed centrally but wide proximally and distally (type V). Patients from type I are considered to be unsuitable for PPVI due to the narrow artery and high probability of device migration.…”

Section: Results On Model Based Patient Selection Suitable For Ppvimentioning

confidence: 99%

“…[5] has proposed a set of measurements: max (RVOT) diameter, min diameter and diameter at the main bifurcation region from which the exact location for anchoring the valve stent is defined [6]. PPVI intervention is avoided by patients with RVOT diameter > 22mm due to device limitation [1,4,5].…”

Section: Results On Clinical Evaluationmentioning

confidence: 99%

“…Percutaneous pulmonary valve implantation (PPVI) [4] is a new developed technique for transcatheter placement of a valve stent. The main difficulties of PPVI are: the assessment of the pulmonary trunk and the right ventricle outflow track (RVOT < 22mm) before treatment [4], the classification of patients suitable for the procedure [5] and identification of the exact location for anchoring the stent [6]. Hence, precise assessment of the morphology and dynamics is crucial for the pre-procedural planning and successful intervention of PPVI.…”

Section: Introductionmentioning

confidence: 99%

“…al. [5] proposed a patient specific 3D model manual extracted from MRI data. Although it may positively impact patient evaluation and procedure planning, the modeling requires a long time, the accuracy is influenced by user experience, and does not include dynamics.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Personalized Pulmonary Trunk Modeling for Intervention Planning and Valve Assessment Estimated from CT Data

Vitanovski

Ionasec

Georgescu

et al. 2009

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2009

View full text Add to dashboard Cite

Abstract. Pulmonary valve disease affects a significant portion of the global population and often occurs in conjunction with other heart dysfunctions. Emerging interventional methods enable percutaneous pulmonary valve implantation, which constitute an alternative to open heart surgery. As minimal invasive procedures become common practice, imaging and non-invasive assessment techniques turn into key clinical tools. In this paper, we propose a novel approach for intervention planning as well as morphological and functional quantification of the pulmonary trunk and valve. An abstraction of the anatomic structures is represented through a four-dimensional, physiological model able to capture large pathological variation. A hierarchical estimation, based on robust learning methods, is applied to identify the patient-specific model parameters from volumetric CT scans. The algorithm involves detection of piecewise affine parameters, fast centre-line computation and local surface delineation. The estimated personalized model enables for efficient and precise quantification of function and morphology. This ability may have impact on the assessment and surgical interventions of the pulmonary valve and trunk. Experiments performed on 50 cardiac computer tomography sequences demonstrated the average speed of 202 seconds and accuracy of 2.2mm for the proposed approach. An initial clinical validation yielded a significant correlation between model-based and expert measurements. To the best of our knowledge this is the first dynamic model of the pulmonary trunk and right ventricle outflow track estimated from CT data.

show abstract

“…The morphology of the pulmonary trunk is a major determinant of suitability for PPVI [5]. Intervention in unsuitable patients exposes patients to unnecessary invasive catherization.…”

Section: Results On Model Based Patient Selection Suitable For Ppvimentioning

confidence: 99%

Section: Results On Model Based Patient Selection Suitable For Ppvimentioning

confidence: 99%