hybrid cath lab solutions
TRANSCRIPT
Hybrid cath lab solutionsCreating new therapeutic opportunities in interventional cardiology
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As invasive procedures such as aortic valve
replacements, mitral valve repairs, and epicardial
ablations of ventricular tachycardias enter the
field of interventional cardiology, medical
institutions are increasingly exploring the
possibility of installing a hybrid catheterization
lab. By fulfilling the requirements of advanced
imaging and an operating room, next-generation
cath labs are ideally suited for performing new
therapeutic procedures. They also help to improve
the quality and cost-effectiveness of patient
care by expanding your room capabilities and
broadening your procedure mix.
Designing and installing a hybrid cath lab spe-
cifically customized to your needs – current and
future – requires a dedicated team of experts.
Siemens has extensive cardiology expertise and
experience. With its forward-oriented Artis zee
family of imaging systems and advanced applica-
tions, it also possesses one of the most progressive
cath lab solution portfolios on the market today.
Expanding the capabilities of your cath lab
A. Vahanian et al., “Transcatheter valve implantation for patients withaortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC),” Eur J Cardiothorac Surg (2008), doi:10.1016/j.ejcts.2008.04.039
The optimal environment for TAVI should be spacious and sterile, and feature high-quality imaging equipment. A hybrid suite is ideal as it fulfills the role of both an oper ating room and a catheterization laboratory. Howev-er, most institutions do not have a hybrid room available, thus the organizational and financial implications of acquir-
ing one, which is highly desirable, cannot be overlooked.
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Aortic valve implants with enhanced guidanceAlthough 2D fluoroscopy continues to be the gold standard in interventional
cardiology, it has limitations. Advanced 3D imaging tools can significantly
enhance planning and guidance during valve deployment.
syngo DynaCT Cardiac image of the aortic root
syngo DynaCT Cardiac
After a 5-second rotational angiography run with a maximum of
25 ml contrast agent the special syngo DynaCT Cardiac recon-
struction algorithms create CT-like images of the aortic root and
its surrounding structures. The anatomical information provided
by the 3D visualization of the aortic root and the ascending aorta
can assist physicians in planning the valve implantation.
Segmentation of the aortic root, including anatomical
landmarks
syngo Aortic ValveGuide*
Starting with syngo DynaCT Cardiac images as the basis,
syngo Aortic ValveGuide achieves a whole new level of valve
positioning convenience. The software provides a segmentation
of the aortic root that indicates the ideal perpendicular projec-
tion for valve deployment, along with landmarks – completely
automatically, in less than 10 seconds. The C-arm projection can
be synchronized with the 3D view, thereby saving time and dose
as compared to fluoroscopy guidance alone.
3D guidance during valve deployment with
syngo iPilot
syngo iPilot
By simultaneously displaying the live fluoro image and matching
syngo Aortic ValveGuide segmentation result, syngo iPilot creates a
2D/3D overlay to facilitate valve positioning before inflation.
Accurate and precise positioning of the valve can be confirmed
with a new 3D image and overlay.
* Work in progress. The information about this product is preliminary. The product is under development and not commercially available in the U.S., and its future availability cannot be ensured.4
Imaging Excellence
Cardiac resynchronizationtherapy with less contrast mediaBiventricular lead placements are regarded as challenging interventions.
Angiographic coronary sinus (CS) visualizations generally require lots of
contrast media and fluoroscopy. 3D visualizations of the coronary sinus can
facilitate lead placements as well as decrease procedure time.
2D/3D overlay of the live fluoroscopy and segment-ed coronary sinus to guide the lead implantation
Rotational angiography of the coronary veins with syngo DynaCT Cardiac
Segmented coronary sinus with blue C-arm in upper right hand corner showing actual projection
Integrating a 3D reconstruction with the real-time fluoroscopy
image, syngo iPilot supports very efficient guidance during
the implantation of the transvenous pacing leads into the target
vein. No additional contrast injections are needed to visualize
the CS. During the procedure, projection changes are dynami-
cally adapted.
syngo iPilot
This application uses a syngo DynaCT Cardiac run and less than
30 ml contrast agent to create a 3D reconstruction of the coro-
nary veins – during the procedure. An inflated balloon is used
to occlude the coronary sinus. The high-resolution imaging
of syngo DynaCT Cardiac can also assist with critical decisions,
for example, whether interventional treatment or open-heart
surgery is the best option.
syngo DynaCT Cardiac
Anatomical characteristics are clearly revealed through the
segmentation of the coronary sinus with syngo InSpace 3D.
By synchronizing the C-arm angulation and rotation with the
3D segmentation, the application helps to find the optimal
projection – without the need for additional contrast media
and fluoroscopy.
syngo InSpace 3D
For more information, visit us at www.siemens.com/hybrid-cathlab
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Artis zee Cockpit
Featuring a 30’’ medical-grade monitor, the Artis zee
Cockpit can display up to six sources on one screen –
simultaneously. Screen layouts can be changed with
a simple mouse click. The unique drag & drop func-
tionality lets you easily rearrange image scans to
display clinical data the way you like it.
A floor-mounted imaging system such as Artis zeego offers clear
advantages in meeting a hybrid room’s high sterility standards.
The ceiling over the sterile OR field is kept free from system compo-
nents, which could interfere with surgical lights or laminar airflow.
The system enables highly flexible positioning around the patient.
In the park position, the C-arm is completely out of the way for easy
patient access.
Artis zeego – dedicated imaging for hybrid procedures
• Unique positioning capabilities
• Ergonomic design with flexible working height and variable isocenter
• Integrated table with tilt, cradle and synchronized tracking
• Innovative 3D imaging capabilities with syngo DynaCT Cardiac
• Ideally suited for institutions interested in conducting new interventional treatments
• Innovative 3D imaging capabilities with syngo DynaCT Cardiac
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Hybrid starts with high-end imaging
Equipped with advanced imaging technolo-gy, a hybrid cath lab can provide exceptional flexibility and support for a wide range of cardiovascular procedures, structural heart diseases as well as cardiac resynchronization therapy. Artis zee solutions for hybrid cath- labs are designed to make your workflow smart, easy and efficient.
Tableside control
Artis zee systems feature a new user interface with a compact design as well as easy-to-read syngo icons for quick task card selection. Customized workflow setups and integrated mouse control offer additional operating con-venience.
Intraprocedural 3D imaging
Complex interventions such as valvular disease therapies can benefit from additional anatomi-cal information provided by advanced 3D imag-ing. Artis zee systems incorporate enhanced syngo imaging applications such as reconstruc-tion, segmentation and landmarks of 3D struc-tures acquired during the intervention.
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Integrated interventional table with OR capabilities
Interventional cardiologists and surgeons
have different table requirements. Siemens
has developed an integrated OR table that
supports high-end imaging applications. The
table features motorized vertical and lateral
tilt movements for invasive interventions as
well as a four way floating tabletop.
Artis zee Large Display
Featuring a 56-inch medical-grade screen
and 8-megapixel image resolution, the
Artis zee Large Display provides customized
clinical images and information on one
screen – with up to 21 video source inputs.
It can also be used to monitor other rooms
and to support telemedicine, endoscopy
and ultrasound applications.
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Artis zee biplane system – first choice for pediatrics
• Second isocentric working position provides full patient coverage from head to toe
• Unique left side position gives anesthesiologist generous access to the patient’s head
• Ideally suited for treating patients particularly vulnerable to the effects of contrast media, e.g. pediatric patients
Artis zee floor-mounted system – the compact solution
• With its extra small footprint, this system fits into virtually any cath lab
• System movements do not interfere with the laminar flow or pass over the sterile field
• MultispaceF and rotatable integrated OR table enable unique positioning flexibility for a conventional floor- mounted system
• 3D imaging capabilities of syngo DynaCT Cardiac support complex structural interventions
• Ideally suited for reducing the risk of contamination- related infections in the surgical environment
Artis zee ceiling-mounted system – the flexible all rounder
• C-arm and flat detector positioning flexibility allows imaging from all angles around the patient while maintain- ing the anatomical orientation of the displayed images
• InFocus and Isotilt uphold the projection on the region of interest during gantry movements and integrated OR table tilting
• syngo DynaCT acquisition from left/right side allows 3D imaging of peripheral regions
• Ideally suited for cath labs with high percentage of peripheral cases
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Enhanced Workflow
Hybrid starts with high-end imaging
Equipped with advanced imaging technology, a
hybrid cath lab can provide exceptional flexibility
and support for a wide range of cardiovascular
procedures, structural heart diseases as well as
cardiac resynchronization therapy. Artis zee solu-
tions for hybrid cath labs are designed to make
your workflow smart, easy and efficient.
Preparation areaStorage Equipment
Control room
Cath lab
850
850
At Siemens, hybrid cath lab competence extends far beyond simply
installing imaging systems. Our dedicated team of experts will work
closely with you in designing a suite customized precisely to your
needs – everything from the room planning to the setup and imple-
mentation, including the selection of an appropriate imaging sys-
tem and applications, monitor booms, anesthesia equipment and
surgical lighting.
Specializing in user-centric cath lab designs
Our planning experts design roomlayouts to optimally support workflow
One-stop hybrid expertise – Siemens turnkey hybrid solutions cover:
• All construction and/or renovationservices of healthcare facilities
• Everything from consulting to plan-ning, implementation and partnership
• Multi-vendor product compatibilityand coordination
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Planning
When designing a hybrid cath lab, two factors are particularly important: space requirements and the intended use of the room. Ideally, the room should offer maximum flexibility for handling a wide range of cardiovascular applications as well as fulfill your therapeutic needs over the long term. It should be
equipped with advanced imaging capabilities that support minimally invasive coronary interventions at low dose as well as create an OR environment that supports cardiac device implants for treating structural heart disease and rhythm disorders.
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Compared with a conventional cath lab, the added expenditures
for a hybrid room setup appear considerable. However, a hybrid
cath lab can position a hospital as an innovative healthcare provider,
one that offers a higher level of care.
The higher investment is also justified by the potential for new treatment opportunities and additional patients. For example, percutaneous valve implantations offer an alterna-tive for high-risk patients previously considered untreatable. In addition, a hybrid environ-ment allows emergency surgical intervention in the event of complications.
As a leading provider of advanced cath lab and surgical suite solutions, Siemens hasextensive experience in designing and furnishing customized hybrid rooms.
At the forefront of developments in cardiology
Cardio-Thoracic Center, Monaco COROSKOP
1990
Heart Center, Leipzig, GermanyAXIOM Artis dTA
2004
German Heart Center, Munich, GermanyAXIOM Artis dFC
2007
Today more than 300
hybrid suites worldwide
installed by Siemens.
Investment Confidence
NewYork - Presbyterian, New York, NY, USA Artis zeego
2009
UCL Saint Luc, Brussels, BelgiumArtis zeego
2008
Siemens helped us plan and set it up. An Artis zeego forms the centerpiece of our new hybrid room, which gives us tremendous treatment flexibility.
Dr. Bernard De Bruyne, Head of Cardiology, Cardiovascular Centre Aalst,
Belgium
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On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice.
Some/All of the features and products described herein may not be available in the United States or other countries.The information in this document contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases.
Siemens reserves the right to modify the design, packaging, specifications and options described herein without prior notice. Please contact your local Siemens sales representative for the most current information.
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