Method to measure the 3D angular orientation of the aortic valve plane from a single image of a valvuloplasty balloon: Findings of a large animal proof of concept experiment

Abstract

During transcatheter aortic valve replacement procedures, alignment of the interventional x-ray beam with the aortic valve plane is required to guide valve placement. The purpose of this work was to develop methods to measure x-ray beam angles which are aligned with the aortic valve plane from a single x-ray image of a valvuloplasty balloon inflated across the left ventricular outflow tract (LVOT). A custom valvuloplasty balloon and image analytics were developed. In-vivo pig experiments demonstrated that the angular orientation of the LVOT can be measured with precision less than 3°, including the influence of cardiac motion during rapid pacing. Using these methods, the angular orientation of the LVOT of a large mammal can be measured precisely and the continuous range of x-ray projection angles which are aligned with the aortic valve plane can be calculated.

• 3D angular orientation
• aortic valve
• interventional x-ray imaging
• transcatheter aortic valve replacement

Acknowledgements

This study was funded by a Mayo Clinic, Rochester, MN, Division of Cardiovascular Diseases, Small Projects Grant.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.