経皮的大動脈弁置換術（TAVR）における3Dナビゲーションシステム使用経験

概要

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Transcatheter aortic valve replacement becomes the topics as low invasive surgery for the high-risk aortic stenosis worldwide. The AVI Support prototype was introduced in our institution, and is used for 3D-Navigation system. The purpose of this study is to examine the optimization and usefulness of the 3D-Navigation system in TAVR.In this study, I evaluated the 3D reconfiguration image by the difference in Dyna-CT imaging condition,and the gap of the most suitable angle calculated from AVI Support prototype and preoperatine images. And also I elucidated clinical impacts.Regarding 3D reconfiguration image, reduction of the contrast media consumption is possible by the triple attenuant imaging with the saline, I could secure enough imaging in clinical. In addition, Iconfirmed improvement of a picture by rapid-pacing and breath-holding. Some gaps occurred between the most suitable angle calculated from AVI Support prototype and preoperatine images.In conclusion, the AVI Support prototype got the most suitable angle calculation so quickly. In addition, the AVI Support prototype is the very useful tool to get precise three dimensional image, furthermore it may be able to reduce total contrast media consumption.
日本医療機器学会の論文