Novel 3-Dimensional Image Fusion Software for Live Guidance of Percutaneous Pulmonary Valve Implantation

A 7-year-old patient (28 kg) born with aortic stenosis, having undergone the Ross procedure and a repeat surgical intervention including patch plasty of the stenosed conduit and mechanical valve implantation in the mitral position, presented with recurrence of right ventricular outflow tract conduit narrowing.Transthoracic echocardiography showed obstruction of the conduit (Vmax=4 m/s) with moderate pulmonary regurgitation. Cardiac computed tomography confirmed stenosis of the graft with a minimum diameter of 12×18 mm, unobstructed pulmonary arteries, and coronary arteries sufficiently separated from the graft.The computed tomography scan was uploaded to the dedicated workstation for processing with the novel VesselNavigator (Philips Healthcare) 3-dimensional (3D) image fusion software. The automatically created 3D reconstruction was manually modified with a single-click segmentation tool (Figure [A]) to …