As a cardiac surgeon, you deal with a lot of challenges: judging the risks of a procedure, determining patients’ tolerance for dose and contrast, and anticipating reinterventions and follow-up procedures. You and your hospitals’ administrators may also be contemplating how to prepare your operating rooms for multidisciplinary use and the surgical innovations of tomorrow.
Siemens Healthcare offers Hybrid OR solutions that equip you to meet those challenges. When positioning valves, performing a bypass, or placing stent grafts, advanced imaging technology provides continuous visualization during your surgical workflow to help you improve clinical outcomes. Our solutions empower you to treat high-risk patients and perform the minimally invasive procedures that will define the operating room of the future – whether you are just about to join the hybrid revolution or already considering a second Hybrid OR.
Transcatheter Aortic Valve Implantation with syngo Aortic Valve Guidance
Precise placement of the valves is the key to success in TAVI. syngo Aortic Valve Guidance supports valve placement workflow with automated 3D image guidance during the procedure.
At the push of a button, the automated workflow starts with a 5 second syngo DynaCT acquisition. Without further user interaction, a 3D image of the segmented aorta marked with anatomic landmarks appears on the in-room monitor. The aortic annulus and the ostia of the coronaries are highlighted in the image.
A virtual ring parallel to the aortic annulus is displayed 1 cm below the segmentation to assist in finding the right angulation for implantation.
The segmentations and landmarks can be overlaid on top of live fluoroscopy and are updated on any change in patient position or angulation. The overlay offers live 3D guidance during implantation, increasing precision and security of TAVI.
"syngo Aortic Valve Guidance makes it so quick and easy for us to find the optimal perpendicular view of the annulus. The software does everything automatically. Based on the DynaCT Cardiac images, it derives the optimal plane for the valve implantation and then we can synchronize the C-arm projection with this view without giving additional root shots."1
Dr. Jörg Kempfert
Heart Center Leipzig, Germany
Image guidance for Hybrid Coronary Revascularization
For patients with multi-vessel-disease, the hybrid operating room opens the door to a one-stop treatment approach. The imaging capabilities in the operating room allow for hybrid coronary revascularization.
This approach represents a minimally invasive alternative strategy that combines the durability and survival advantage of the LIMA-LAD graft with less invasive PCI to treat non-LAD vessels.
A study from Fuwai Hospital in Beijing, China* comparing this hybrid approach with conventional off-pump coronary artery bypass grafting show that recovery times can be shortened. At a mean followup of 18 months, the freedom from major adverse cardiac or cerebrovascular events is in favor of the hybrid group (99.0% vs 90.4%; p=0.03).
For PCI, the angiography system provides the necessary imaging and advanced visualization tools such as CLEARVessel for enhanced vessel contrast and CLEARStent Live for real-time stent enhancement.
A completion angiography with syngo DynaCT Cardiac provides the opportunity to evaluate the success of the treatment right in the operating room.
See CLEARStent Live in action.
* Hu S, Li Q, Gao P, Xiong H, Zheng Z, Li L, Xu B, Gao R. Simultaneous hybrid revascularization versus off-pump coronary artery bypass for multivessel coronary artery disease.
Ann Thorac Surg. 2011; 91(2):432-8
Pulmonary Valve Therapy
In pulmonary valve therapy, surgeons often face very complex anatomies.
Intraoperative 3D imaging can help increase precision and safety in those particularly delicate cases. A reduction of radiation dose and contrast media is possible when the 3D run replaces a series of separate angiograms.
“In addition, even with multiple angios, you cannot obtain the same comfort level and understanding of the complex pulmonary artery anatomy. The 3D angio demonstrated the locations and extent of the stenoses in detail. Rotating the image on the screen and then correlating the flat detector angle results in a accurate road map on the screen; it cannot be duplicated with traditional biplane angiography.”1
Farhouch Berdjis, M.D.
Department of Pediatric Cardiology at St. Joseph Hospital, Orange, CA, USA
Medical Knowledge Corner
Explore our collection of case studies, clinical workflows, videos, brochures and scientific publications for cardiac surgery.
syngo Aortic Valve Guide for TAVI
syngo Aortic Valve Guide - How to video
syngo iPilot - AVG overlay during aortic valve deployment
Transapical Aortic Valve Implantation with syngo DynaCT - Heart Center Leipzig
Transfemoral Aortic Valve Implantation with Artis zeego - Rotenburg (Fulda)
Transapical Aortic Valve Implantation with Artis zeego - Rotenburg (Fulda)