科室会用-产品组Carto Univu科内会#专业参考

1、穿越维度 绿色视野 X线影像整合系统内容简介,Agenda,为什么我们需要整合X线影像?,*Cappato R, et al. Worldwide survey on the methods, efficacy and safety of catheter ablation. Circulation 2005;111(9): 1100-1105 *Calkins, H, et al. Radiation exposure during radiofrequency catheter ablation of accessory atrioventricular connections. Circ

2、ulation 1991;84(6): 2376-2382,如何最大化保证手术的安全？ 如何尽可能多的减少X线的照射？,EP医生正在面临的困难,Always verify catheter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy use,射线照射的长期危害,X射线是一种电离辐射，会引发健康风险 白血病和实体瘤与低剂量射线照射有关7 心脏介入医生的射线照射量是放射科医生的2-3倍以上

3、常年进行心血管介入手术的术者终生患癌风险超过1% 射线对人体的影响往往持续数周或数年,1Picano, op cit. 4Peck, op cit. 6Parks PM. Dangers of high-dose fluoroscopy. Entrepreneur. May-June 2003. 7Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009;361:849-57. 7Fazel R,

4、 Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009;361:849-57.,Always verify catheter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy use,我国放射防护新基本标准,5

5、,专业参考,国际射线照射健康风险指南,1.Food and Drug Administration, Avoidance of Serious X-Ray-Induced Skin Injuries to Patients During Fluoroscopically-Guided Procedures, September 9, 1994,6,专业参考,CARTO 3 System,什么是CARTOUNIVU X线影像整合系统？,CARTO 3 系统与X线影像的整合。 The CartoUNIVU X线影像整合系统是一个完全创新的CARTO 3 System 高级图像整合模块 在CARTO

6、 3 系统上X线影像与3D电解剖图形简单准确的无缝融合,Fluoroscopy,CartoUNIVU Module,Always verify catheter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy use,如何升级？,CartoUNIVU Module Registration Plate 配准板,一个新的硬件组件 + 升级软件,Simple,Always verify cath

7、eter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy use,X光机兼容品牌,*Rotational Angiography Support (180o rotational scan can be sent to CartoUnivu Module),9,专业参考,一个完整统一的视野,可以用于所有CARTO 3 模块* 导管可视 一个结合CARTO 3 系统和X线透视的统一视野 提高手

8、术效率 有效整合X线下手术经验,Always verify catheter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy use,*except Carto 3 System with RMT Module,曝光、电影均可记录、传输和播放 自动计算左右各5影像 自动生成180反转图像，实现双板DSA功能,CARTOUNIVU 模块的临床应用,增强空间定位 结合周围的心脏解剖结构更好的理解

9、导管或图形的位置 实时显示X线二维图像 可在主图和副图上显示两个不同的X线图像 对照造影图像显示解剖结构 在复杂电生理手术中了解血管走形（主动脉根部、先天解剖异常、冠状窦等） 持续描绘肺静脉前庭部位 通过肺静脉造影标记心房、脊部并指导消融 了解食道位置 在导入钡剂增强食道造影图像后可了解食道位置,Always verify catheter tip location using fluoroscopy or IC signals and consult the Carto System User Guide regarding recommendations for fluoroscopy u

10、se,CARTOUNIVU VS CARTO射线照射量对比,4.Alessandra Buiatti, MD, Tilko Reents, MD, Sonia Ammar, MD, Verena Semmler, MD, Katherina Mayer, MD, Felix Bourier, MD, Christian Grebmer, MD, Carsten Lennerz, MD, Monika Hofmann, MD, Susanne Kathan, MD, Christof A. Kolb, MD, PhD, Gabriele Hessling, MD, PhD and Isabel

11、V. Deisenhofer, MD, PhD. Reduced Fluoroscopy Exposure During Ablation of Atrial Fibrillation Using the Novel CartounivuTM Module for Imaging Integration: An Initial Experience, Heart Rhythm, Vol. 11, No. 5, May Supplement 2014,Registration 配准,DSA机头回正到AP位，移动机床至红/绿方块重合,14,专业参考,踩线，完全暴露圆形模块后，传送图像至Carto，

12、 UNIVU自识别到完整模块后，完成注册,Registration配准,15,专业参考,工具栏介绍,A. Rotate view to the most recent capture 跳跃至最新一张图像（使用中发现X线图像传输成功与否也会在此图标上显示并显示各种报错） B. Rotate view to the closest capture 跳跃到上一张图像 C. make the displayed capture a favorite 选择最常用的图像（橙色为选择状态） D. play cine 播放电影 E. automatic/manual capture import mode 是

13、否自动读取图像 F. manual import of the most recent capture 读取最新的图像 G. delete the displayedframe 删除画面 delete the displayed capture 删除图像 delete all capture in the projection 删除所有数据 H. enable/disable manual alignment 手动对齐 I. restore original alignment 撤销上一步对齐,17,专业参考,术中所需体位经验分享,PVC：AP/RAO/LAO/特殊体位,AP位下采集图像，UN

14、IVU可自动生成PA位图像,19,专业参考,RAO/LAO不需额外踩线可直接造影，通过定格造影图像获取,20,专业参考,典型房扑：RAO/LAO,21,专业参考,RVOT: AP/PA,22,专业参考,AOS & LV： PA/LAO,23,专业参考,GCV： RAO/PA,24,专业参考,冠脉造影（特殊体位）： 根据需要调整Carto模型至造影体位获取图像（注意头位角度，建议造影时以5整数倍数调整）,25,专业参考,CASE 1. ICD植入术后室速,ECG-Clinical VT,27,专业参考,Mapping-Clinical VT,28,专业参考,CASE 2. 阵发性房颤+CTI,Mapping MA,30,专业参考,Mapping LA,31,专业参考,Ablation,32,专业参考,Ablation CTI,33,专业参考,Clinical Benefits,曝光时间：5分7秒 总剂量57mGy,34,专业参考,与竞争产品的比较,AF/AF