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OBJECTIVE:
To evaulate the use of a novel, table-mounted mobile fluoroscopy arm in transcatheter aortic valve implantation.
METHODS:
We evaluated the use of a new generation table-controlled four-axis fully motorized fluoroscopy arm (Ziehm Vision RFD Hybrid Edition) in 7 patients during transcatheter aortic valve implantation. C-arm positioning was almost entirely performed via a sterile table-mounted position control joystick. The optimal implantation plane was and the PA position were preprogrammed and saved according to CT calculations. Changes in magnification and collimators position were performed via a draped touch screen monitor.
RESULTS:
Out of 7 patients, four underwent transfemoral, 2 transaortic and 1 transapical aortic valve implantation with balloon expandable valves (SAPIEN XT and SAPIEN 3, Edwards Lifesciences). OR and fluoroscopy time was 122+/-63 min and 14+/-8 min respectively. Mean dose area product was 5036.8 mGy/cm² +/-1058.4 mGy/cm². In one transaortic patient a coronary protection technique with positioning of an non-inflated drug eluting stent in the proximal left anterior descending artery was used due to low offspring of the left coronary artery. None/trace or mild paravalvular regurgitation was observed in 5 patients and 2 patients respectively. Post expansion dilatation was used in one patient. No overheating, uncontrolled movements or collisions with surgeons and OR equipment were noted after activation of the distance control surface recognition.
CONCLUSIONS:
Novel table-controlled mobile fluoroscopy arms are useful tools for OR-based trancatheter valve implantations, especially in departments with financial or space limitations precluding the use of a hybrid OR.