Milan 4 June – Today a lot of heart disease can be treated much more effectively than in the past, because the heart and its complex structures (ventricles, muscles, blood flow in the inlet and outlet valves) can be displayed in 3D high resolution and, if necessary, in dynamic – that is in action. These advances are the result of production methods of clinical images that researchers of Corporate Technology, together with colleagues from Siemens Medical Clinic and the cooperation partners have developed, improved continuously and, in case, combined to make possible new applications.
Thanks to decades of research in ‘ area of clinical images from the doctors, with the support of Siemens scientists, much progress has been made in view of the heart and in terms of its treatment, from arrhythmias to the diseases of the aortic valve.
The focal point of the new applications are the methods and innovative computing hardware enhancements developed by researchers of the TCF sector in Princeton, New Jersey. For years, these researchers have been at the forefront in developing a software for the evaluation of data provided by medical equipment. For example, a group of Princeton researchers used a combination of images or CT or MRI and the representation of the electrophysiological activity of the heart to produce an essential contribution to the development of a minimally invasive method for the treatment of cardiac arrhythmias and that speeds up the procedure associated therapeutic, improving meanwhile the results.
Images pre-operative and catheter navigation
Cardiac arrhythmias, and in particular atrial fibrillation, disorders have become very common because they are often caused by other common medical conditions such as hypertension, diabetes or obesity, affecting mostly older patients. In healthy individuals, cardiac cells special transmit electrical signals to those muscle, in such a way that they can cooperate in an optimal way and in synchronism. However, this interaction does not work properly if there are too many unnecessary cardiac electrical signals. The initial treatment of cardiac arrhythmias is done with drugs, although they do not always remain effective in the long term. Alternatively, the cardiac cells that produce signals routed evil may be electrically neutralized and removed by ablation by means of a catheter in a minimally invasive procedure.
For this procedure, it is essential for the operator to have a good definition spatial organ: in particular, the physician must clearly see in real time the movement of the catheter with respect to the anatomy of the atrium / ventricle. This is made possible by an integrated system that combines the preoperative CT or MRI scans with the data obtained during the surgery. 3D tomographic images of the heart are recorded before surgery and give executives the precise contours, In the intervention, the doctor inserts a catheter into the ventricle sensing; the catheter measures the electrical voltages in the ventricle, while the electromagnetic system of localization provides the coordinates of the points where the voltages were detected, The software then combines the anatomy from 3D images previously registered with the values just measured and provides the map electro-anatomical heart.
The operator of the catheter seen on the monitor can use this map and 3D images to maneuver the catheter within the patient with greater safety and speed.
Research projects of this level are frequently directed to create a product for the future, starting right from the beginning. The field of application is clearly defined – in this case, involves a disease that can no longer be adequately treated with drugs. The collaboration between researchers TAC, those of Siemens Healthcare and partners of the latter led to the transformation of results in products that are then made available to patients: the aim of the research was the development of software that would marry the two images heart in a single framework.
The research in Princeton is also helping other common procedures such as the insertion of stents. Eg., A group of scientists investigates how we can improve imaging during angioplasty: their method provides a procedure by which the coronary arteries are dangerously ristrettesi riallargate with a methodical and protected by a minimum invasibilità happen again with the constrictions a wire mesh called stents. In this method, the operator inserts a catheter to the point of narrowing of the vessel; by movement data to the heart rate, the position of the stent is not clear under the rays B. The software developed by researchers provides aid for compensation of cardiac movements and provides substantially better images, in which the movements of the stent can be frozen . In addition, a series of recorded images in a sequence can be combined into a single image; this process average over time increases the contrast in the image of the stent and reduces the background noise.
A third example of how the Princeton group is helping to improve the cardiac methods is the use of a catheter to insert a new aortic valve.
In the past, doctors could only replace heart valves with open-heart surgery: Many patients, however, are too weak to bear such an intervention and are now aided by a new technology that allows the replacement of heart valves with the use of a catheter. The procedure is much less risky and does not provide for open heart surgery: in Europe at the end of 2014 have undergone valve replacement with catheter over 150 patients with a mean age of 78 years.
by Pictures of the Future Oct. 2014
Katrin Nikolaus
AG
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