scholarly journals Aortography Keypoint Tracking for Transcatheter Aortic Valve Implantation Based on Multi-Task Learning

2021 ◽  
Vol 8 ◽  
Author(s):  
Viacheslav V. Danilov ◽  
Kirill Yu. Klyshnikov ◽  
Olga M. Gerget ◽  
Igor P. Skirnevsky ◽  
Anton G. Kutikhin ◽  
...  

Currently, transcatheter aortic valve implantation (TAVI) represents the most efficient treatment option for patients with aortic stenosis, yet its clinical outcomes largely depend on the accuracy of valve positioning that is frequently complicated when routine imaging modalities are applied. Therefore, existing limitations of perioperative imaging underscore the need for the development of novel visual assistance systems enabling accurate procedures. In this paper, we propose an original multi-task learning-based algorithm for tracking the location of anatomical landmarks and labeling critical keypoints on both aortic valve and delivery system during TAVI. In order to optimize the speed and precision of labeling, we designed nine neural networks and then tested them to predict 11 keypoints of interest. These models were based on a variety of neural network architectures, namely MobileNet V2, ResNet V2, Inception V3, Inception ResNet V2 and EfficientNet B5. During training and validation, ResNet V2 and MobileNet V2 architectures showed the best prediction accuracy/time ratio, predicting keypoint labels and coordinates with 97/96% accuracy and 4.7/5.6% mean absolute error, respectively. Our study provides evidence that neural networks with these architectures are capable to perform real-time predictions of aortic valve and delivery system location, thereby contributing to the proper valve positioning during TAVI.

2012 ◽  
Vol 28 (1) ◽  
pp. 14-15
Author(s):  
Vito Giovanni Ruggieri ◽  
Carine Ridard ◽  
Marc Bedossa ◽  
Xavier Beneux ◽  
Jean-Philippe Verhoye

Author(s):  
Christoph Krapf ◽  
Niklas Altaner ◽  
Judith Martini ◽  
Gabriel Putzer ◽  
Benjamin Rudolf ◽  
...  

Objective Patients undergoing transcatheter aortic valve implantation (TAVI) frequently present with chronic kidney disease and are therefore particularly susceptible to nephrotoxic influences like iodinated contrast media. Acute kidney injury after TAVI is a severe complication that independently predicts short- and long-term mortality. The present study investigates the feasibility of a contrast-free approach by using intravascular ultrasound (IVUS) in conjunction with fluoroscopy. Methods Six domestic pigs (60 ± 5 kg) were anesthetized and underwent transapical implantation of a balloon-expandable transcatheter heart valve. In the control group ( n = 3), the procedures were guided by fluoroscopy/angiography. In the study group ( n = 3), the procedures were guided by IVUS for preimplantation evaluation, intra-procedural guidance, and post-implantation evaluation, in conjunction with fluoroscopy without contrast. The procedures were evaluated by IVUS, fluoroscopy, aortic root angiography, and explantation and dissection of the hearts. Results Relevant anatomical landmarks for correct implantation were assessed by IVUS. The following annulus measurements were obtained: area (359.67 ± 29.58 mm2), perimeter (68.28 ± 2.63 mm), maximum diameter (22.20 ± 1.22 mm), minimum diameter (20.43 ± 1.12 mm), mean diameter (21.32 ± 0.70 mm), ellipticity index (1.09 ± 0.10), and area-derived diameter (21.39 ± 0.87 mm). IVUS-guided valve deployment resulted in correct expansion within the aortic annulus without signs of paravalvular leak, compromised mitral valve, or coronary obstruction. IVUS-guided post-implantation assessment confirmed circular expansion (25.88 ± 0.30 mm) of the valves. Conclusions IVUS-guided, contrast-free transapical TAVI is feasible in a porcine model.


2012 ◽  
Vol 27 (4) ◽  
pp. 438-440 ◽  
Author(s):  
Luis Nombela-Franco ◽  
Josep Rodés-Cabau ◽  
Daniel Doyle ◽  
Robert DeLarochellière ◽  
Marina Urena ◽  
...  

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