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Reliability and Influence on Decision Making of fully-automated vs. semi-automated Software Packages for Procedural Planning in TAVI.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-07-01 , DOI: 10.1038/s41598-020-67111-5
Alexander Meyer 1, 2, 3 , Markus Kofler 1, 4 , Matteo Montagner 1 , Axel Unbehaun 1, 3 , Simon Sündermann 1, 5 , Semih Buz 1 , Christoph Klein 6 , Christof Stamm 1, 2 , Natalia Solowjowa 1 , Maximilian Y Emmert 1, 2, 5 , Volkmar Falk 1, 2, 5, 7 , Jörg Kempfert 1, 2
Affiliation  

Precise procedural planning is crucial to achieve excellent results in patients undergoing Transcatheter aortic valve implantation (TAVI). The aim of this study was to compare the semi-automated 3mensio (3 m) software to the fully-automated HeartNavigator3 (HN) software. We randomly selected 100 patients from our in-house TAVI-registry and compared aortic annulus and perimeter as well as coronary distances between 3m-measurements and post-hoc HN-measurements. Finally, we retrospectively simulated prosthesis choice based on HN-measurements and analyzed the differences compared to routinely used 3 m based strategy. We observed significant differences between the two software packages regarding area (3 m 464 ± 88 mm², HN 482 ± 96 mm², p < 0.001), perimeter (3 m 77 ± 7 mm, HN 79 ± 8 mm, p < 0.001) and coronary distances (LCA: 3 m 13 ± 3 mm, HN 12 ± 3 mm, p < 0.001; RCA: 3 m 16 ± 3 mm, HN 15 ± 3 mm, p < 0.001). Prosthesis choice simulation based on newly obtained HN-measurements would have led to a decision change in 18% of patients, with a further reduction to 4% following manual adjustment of HN-measurements. The fully-automatic HN-software provides higher values for annular metrics and lower annulus-to-coronary-ostia distances compared to 3m-software. Measurement differences did not influence clinical outcome. Both, the HN-software and the 3m-software are sophisticated, reliable and easy to use for the clinician. Manual adjustment of HN-measurements may increase precision in complex aortic annulus anatomy.



中文翻译:

TAVI中用于程序规划的全自动与半自动化软件包的可靠性及其对决策的影响。

精确的手术计划对于在接受经导管主动脉瓣植入术(TAVI)的患者中获得出色的结果至关重要。这项研究的目的是将半自动化的3mensio(3 m)软件与全自动的HeartNavigator3(HN)软件进行比较。我们从内部TAVI登记处随机选择了100名患者,比较了3m测量值与事后HN测量值之间的主动脉瓣环和周长以及冠状动脉距离。最后,我们回顾性地模拟了基于HN测量的假体选择,并分析了与常规使用的基于3 m的策略相比的差异。我们观察到两个软件包在面积(3 m 464±88mm²,HN 482±96mm²,p <0.001),周长(3 m 77±7 mm,HN 79±8 mm,p <0.001)和冠状动脉距离(LCA:3 m 13±3 mm,HN 12±3毫米,p <0.001; RCA:3 m 16±3 mm,HN 15±3 mm,p <0.001)。基于新获得的HN测量值的假体选择模拟将导致18%的患者做出决策更改,并且在手动调整HN测量值后进一步减少到4%。与3m软件相比,全自动的HN软件为环形指标提供了更高的值,并且环与冠状动脉口的距离更短。测量差异不影响临床结果。HN软件和3m软件都对临床医生而言是复杂,可靠且易于使用的。手动调整HN测量值可以提高复杂的主动脉瓣环解剖结构的精度。基于新获得的HN测量值的假体选择模拟将导致18%的患者做出决策更改,并且在手动调整HN测量值后进一步减少到4%。与3m软件相比,全自动的HN软件可提供更高的环形指标值和更低的环面至冠状动脉口距离。测量差异不影响临床结果。HN软件和3m软件都对临床医生而言是复杂,可靠且易于使用的。手动调整HN测量值可以提高复杂的主动脉瓣环解剖结构的精度。基于新获得的HN测量值的假体选择模拟将导致18%的患者做出决策更改,并且在手动调整HN测量值之后进一步降低到4%。与3m软件相比,全自动的HN软件为环形指标提供了更高的值,并且环与冠状动脉口的距离更短。测量差异不影响临床结果。HN软件和3m软件都是成熟,可靠且易于使用的临床医生。手动调整HN测量值可以提高复杂的主动脉瓣环解剖结构的精度。测量差异不影响临床结果。HN软件和3m软件都对临床医生而言是复杂,可靠且易于使用的。手动调整HN测量值可以提高复杂的主动脉瓣环解剖结构的精度。测量差异不影响临床结果。HN软件和3m软件都是成熟,可靠且易于使用的临床医生。手动调整HN测量值可以提高复杂的主动脉瓣环解剖结构的精度。

更新日期:2020-07-01
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