Pediatric Cardiology

, Volume 38, Issue 6, pp 1133–1142 | Cite as

Novel Three-Dimensional Image Fusion Software to Facilitate Guidance of Complex Cardiac Catheterization

3D image fusion for interventions in CHD
  • Sebastian GorecznyEmail author
  • Pawel Dryzek
  • Gareth J. Morgan
  • Maciej Lukaszewski
  • Jadwiga A. Moll
  • Tomasz Moszura
Original Article


We report initial experience with novel three-dimensional (3D) image fusion software for guidance of transcatheter interventions in congenital heart disease. Developments in fusion imaging have facilitated the integration of 3D roadmaps from computed tomography or magnetic resonance imaging datasets. The latest software allows live fusion of two-dimensional (2D) fluoroscopy with pre-registered 3D roadmaps. We reviewed all cardiac catheterizations guided with this software (Philips VesselNavigator). Pre-catheterization imaging and catheterization data were collected focusing on fusion of 3D roadmap, intervention guidance, contrast and radiation exposure. From 09/2015 until 06/2016, VesselNavigator was applied in 34 patients for guidance (n = 28) or planning (n = 6) of cardiac catheterization. In all 28 patients successful 2D–3D registration was performed. Bony structures combined with the cardiovascular silhouette were used for fusion in 26 patients (93%), calcifications in 9 (32%), previously implanted devices in 8 (29%) and low-volume contrast injection in 7 patients (25%). Accurate initial 3D roadmap alignment was achieved in 25 patients (89%). Six patients (22%) required realignment during the procedure due to distortion of the anatomy after introduction of stiff equipment. Overall, VesselNavigator was applied successfully in 27 patients (96%) without any complications related to 3D image overlay. VesselNavigator was useful in guidance of nearly all of cardiac catheterizations. The combination of anatomical markers and low-volume contrast injections allowed reliable 2D–3D registration in the vast majority of patients.


3D guidance Road mapping Stenting VesselNavigator 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

246_2017_1627_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 18 kb)
246_2017_1627_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 20 kb)
246_2017_1627_MOESM3_ESM.docx (19 kb)
Supplementary material 3 (DOCX 18 kb)

Video 1 VesselNavigator assisted percutaneous pulmonary valve implantation in an 11 year-old patient with common arterial trunk after homograft repair. Supplementary material 4 (MP4 26431 kb)

Video 2 VesselNavigator assisted recoarctation stenting in a 13 year-old patient. Supplementary material 5 (MP4 18747 kb)

Video 3 VesselNavigator assisted ductus arteriosus stent implantation in a neonate with hypoplastic left heart syndrome after bilateral pulmonary artery banding. Supplementary material 6 (MP4 24475 kb)

Video 4. VesselNavigator assisted hypoplastic left pulmonary artery stent implantation in a 6 year-old with tetralogy of Fallot after homograft repair. Supplementary material 7 (MP4 34318 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of CardiologyPolish Mother’s Memorial Hospital, Research InstituteLodzPoland
  2. 2.Heart Institute, Children’s Hospital of Colorado & Department of Adult Congenital Heart DiseaseUniversity of Colorado HospitalDenverUSA
  3. 3.Department of RadiologyPolish Mother’s Memorial Hospital, Research InstituteLodzPoland

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