For the preparation of this procedure, SOMATOM Definition Flash brings even more benefits to the user. TAVI patients are usually multimorbid and suffer from renal insufficiency. They can barely metabolize larger quantities of contrast agent that often have to be applied for a CTA to display the coronary arteries and the aorta.

"For us, SOMATOM Definition Flash is the best solution to plan a TAVI because it allows us to reduce contrast agent significantly," said Tobias Pflederer, MD, cardiologist at University Hospital Erlangen, Germany. "Single-Source CTs, for example, require 100 or even 150 milliliters of contrast agent for assessing the abdominal aorta. With the Definition Flash, we need only 40 milliliters for the aorta and the coronary arteries." The cardiologists in Erlangen only need two seconds to assess the whole aorta including the coronary arteries in one scan. "Using the resulting information, we can plan every single step of the TAVI procedure," said Pflederer.


Prior to the TAVI treatment, the cardiologists need to clarify many anatomical issues regarding the vessels. They must know, for example, whether there are stenoses in the peripheral arteries. In that case, they could not insert the new valve through the femoral artery. Furthermore, they must determine the diameter of the aortic bulbus (initial part of the aorta) to select the right size of the artificial valve. syngo.via combines the application modules syngo.CT Vascular Analysis and syngo.CT Cardiac Function to display a dedicated TAVI planning workflow that helps physicians answer all these questions quickly, easily, and securely. The software, for instance, automatically exposes the aorta and its valves virtually. It reconstructs the vessel in the most important planes and automatically indicates the measurements that the physician has to conduct for his diagnosis.

"With syngo.via, we are also able to predict the angulations that we will need for invasive fluoroscopy in the TAVI procedure, and we can load and adjust them right in the cath lab," said Pflederer. "Our first experiences are that this way, the workflow inside the cath lab can be accelerated by 30 percent." The University Hospital Erlangen conducts three to four TAVI interventions per week. Pflederer believes that the quantity will increase and that TAVI then may also be used for non-high-risk patients. He assumes that soon, other valve diseases may be treated by transcatheter approaches, as well.

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