CT-US Registration for Guidance of Transcatheter Aortic Valve Implantation

摘要

Transcatheter aortic valve implantation is a minimally invasive procedure that delivers a replacement aortic valve to a beating heart using a valved stent in a catheter delivered either transapically or via the femoral artery. Current image guidance of this procedure relies on fluoroscopy, which provides poor visualization of cardiac anatomy. Combining a preoperative CT with intraoperative TEE images into a common environment would allow for improved image-guidance using only standard clinical images. A fast intraoperative registration of these images based on an iterative closest point registration is proposed and validated on human images. Three methods of extracting surface points from the TEE images are compared: 1) Biplane images outlined manually, 2) Multiple planes from the 3D TEE outlined manually, and 3) An automatically extracted surface from 3D TEE. Results from this initial validation demonstrate that a target registration error of less than 5mm may be achieved.