Multimodal image fusion guidance for the treatment of structural heart disease and aortic dissection in hybrid operation room: a single-center case series in a hybrid operating room.

BACKGROUND: Angiography and transesophageal echocardiography are limited by the lack of providing detailed three-dimensional (3D) cardiovascular stereo-anatomy intraoperatively. Currently, numerous researchers have utilized advanced functionalities from various imaging manufacturers to integrate multimodal images for intraoperative navigation. Nevertheless, the clinical application of such techniques is often compromised by suboptimal registration accuracy, primarily attributable to positional changes of the patient across preoperative imaging and intraoperative settings. This study aimed to propose a novel multimodal image fusion method to guide cardiovascular interventions.

METHODS: In this retrospective study, we introduce the image fusion method that integrates preoperative computed tomography angiography (CTA) and intraoperative cone-beam computed tomography (CBCT) to improve 3D real-time fusion navigation in treating structural heart diseases and aortic dissection. Furthermore, this study provides a comprehensive description of the technical details for this method and retrospectively reviews the specific applications of this method in a single-center setting.

RESULTS: Seven cases demonstrated the effectiveness of this technique in enhancing procedural accuracy and outcomes. In these cases, the 3D fusion roadmap provided important navigational information for minimally invasive procedures to accurately implant prosthetic valves and stents. All procedures achieved satisfactory outcomes with reduced fluoroscopic radiation exposure.

CONCLUSIONS: The multimodal image fusion roadmap offers detailed and stereoscopic guidance of cardiovascular minimally invasive treatments. It has great potential to help improve procedural efficiency and reduce complication rates.