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.
ARTIS pheno in cardiology and cardiovascular surgery
The University Hospital of Giessen and Marburg (UKGM) is operating the first ARTIS pheno in cardiology and cardiovascular surgery. Read more about the first experiences with ARTIS pheno in an interview with Prof. Bernhard Schieffer, MD, director of the Clinic of Cardiology, Angiology and Intensive care.
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 with anatomic landmarks appears on the Large Display in-room monitor. The aortic annulus and the ostiae of the coronaries are highlighted in the image.
A virtual ring parallel to the aortic annulus is displayed below the valve to assist in finding the right angulation for implantation.
The segmentations and landmarks can be superimposed on top of fluoroscopy and are updated on any change in patient position or angulation. The overlay offers live 3D guidance during implantation, increasing precision and decreasing contrast media usage during the implantation.
"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
German Heart Center Berlin, 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 follow-up 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
Medical Knowledge Corner
Explore our collection of case studies, clinical workflows, videos, brochures and scientific publications for cardiac surgery.
Better outcomes in TAVI with ARTIS pheno
Transapical Aortic Valve Implantation with Artis zeego - Rotenburg (Fulda)
Scientific Talks and Publications
- Current status of hybrid coronary revascularization. (Jaik et al., Expert Rev Cardiovasc Ther., 2011)
- Hybrid cardiovascular suite: the operating room of the future. (Kpodonu, J Card Surg., 2010)
- Hybrid coronary revascularization: Which patients? When? How? (Bonatti et al., Curr Opin Cardiol., 2010)
- Hybrid options for treating cardiac disease. (Umakanthan et al., Semin Thorac Cardiovasc Surg., 2011)
- Hybrid room technology as a prerequisite for the modern therapy of aortic dissection. (Jakob et al., Herz., 2011)
- Midterm outcomes of simultaneous hybrid coronary artery revascularization for left main coronary artery disease. (Hu et al., Heart Surg Forum, 2012)
- Simultaneous hybrid revascularization by peripheral artery stenting and off-pump coronary artery bypass: the early results. (Wu et al., Ann Thorac Surg., 2011)
- Use of a hybrid operating room to diagnose and treat delayed coronary spasm after mitral valve repair. (Antevil et al., J Thorac Cardiovasc Surg., 2010)