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CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 2, March 2013
AFRICA
47
The burden of acquired heart disease
in adults and children presents a very
real healthcare challenge across the
world. Philips Healthcare’s commitment
to improving access to healthcare
infrastructure in Africa was emphasised
through the hosting of and participation
in dialogues, discussions and workshops
at the sixth World Congress on Paediatric
Cardiology and Cardiac Surgery that
recently took place in Cape Town, South
Africa.
‘Philips is committed to providing
innovative solutions to the challenges
that the African continent currently
faces in the management of cardiology
diagnoses and treatment’, commented
Jose Fernandes, district manager, Philips
Healthcare, Southern Africa. ‘At the
World Congress, we e our extensive
portfolio of products and solutions for
cardiology. These will provide clinicians
a continuum of solutions for 21st-century
cardiac care, customised for them and the
needs of their community.’
Discussions centredonhowinnovations
in interventional radiology treatment
are helping to transform the future of
patient care. These were a platform for
experience-sharing on minimally invasive
cardiology procedures.
Structural heart disease inter-
ventions: the growing wave of
new therapies
The standard imaging procedure for endo-
vascular interventions is invasive biplane
(2D) angiography. Three-dimensional
reconstructions from pre-procedural
computed tomography (CT)/magnetic
resonance (MR) angiography are regard-
ed as major advances in non-invasive
cardiac imaging.
However, with the advent of three-
dimensional rotational angiography
(3DRA) and real-time tomographic
reconstruction of the acquired images, a
volumetric view of the vascular anatomy
can be created. This may optimise decision
making for treatment planning and may
provide improved guidance during the
intervention.
At one of the Philips breakfast
symposia, Dr Thomas Fagan, Children’s
Hospital Colorado in Denver, shared his
experience with multi-modal cardiac
imaging in trans-catheter interventional
paediatric cardiology. He performed
3DRA with the 3DRA Philips Healthcare
system, employing a 4.1-second rotation
of the C-arm. From his experience with
more than 100 patients, he concluded
that in the majority of cases, 3DRA
provides additional clinically useful
information compared with planar biplane
angiography.
Dr Fagan also reported on the use of the
Philips HeartNavigator, an interventional
planning tool. With this tool he was able
to segment the anatomy of interest and
plan the procedure with measurements,
optimal view selection and landmarks.
He then registered this dataset to the
live fluoroscopy in order to obtain live
overlays of the anatomy, enabling him to
perform the procedure under guidance.
Contrast volume could be reduced
and a decrease in need for additional
angiography was observed. This modality
also appeared to improve confidence in
the guidance of catheters. It is envisaged
that 3DRA availability will become
of increasing importance in paediatric
cardiology and that these tools will
afford virtual training in endovascular
procedures.
Finally, Dr Fagan presented his recent
experience with EchoNavigator, the new
Philips platform, which for the first time
‘makes fluoroscopy smart’ by combining
two live imaging modalities: fluoroscopy
and transoesophageal echocardiography
(TEE). The platform registers the two
modalities and re-orients the live 3D
echocardiographic view to match the
fluoroscopic projection angle.
It also gives control to the
interventionalist of the 3D TEE display,
using a tableside mouse to interrogate
the anatomy, rotate and crop the 3D
volume, as well as place markers on the
soft tissue, which then appear on the
fluoroscopy screen. The tool facilitates
communication between interventionalist
and echocardiographer, increases
interventional confidence and enables
the placement of targets and reference
anatomy directly on the fluoroscopy
screen.
Philips Healthcare then introduced
their revolutionary new interventional
X-ray system: AlluraClarity. The
system, built upon an unprecedented
Same image quality at 73% less X-ray dose.
A well attended breakfast symposium – Dr Greil
6th World Congress
Paediatric Cardiology and Cardiac Surgery
Cape Town, February 2013
Philips hosts breakfast symposia to drive experience-sharing on minimally
invasive cardiology procedures