Multimodal Imaging of a Culotte Bifurcation Procedure in the Left Main Coronary Artery of a Perfusion-Fixed Human Heart: Step-by-Step with Serial Micro-CT Analyses.
Thomas F ValenzuelaPaul Anthony IaizzoPublished in: Journal of cardiovascular translational research (2023)
Percutaneous coronary intervention can be a high-risk procedure that would benefit from optimizing device-tissue interactions between stents and coronary vessels. Using a perfusion-fixed human heart with coronary artery disease, we performed a percutaneous coronary intervention of the left main coronary artery bifurcation. This heart was perfused and multimodal imaging was utilized to view the procedure with direct visualization, fluoroscopy, and optical coherence tomography (OCT). We followed the European Bifurcation Club's guidelines to perform a single-stent bifurcation before transitioning to a two-stent Culotte technique. After each procedural step, the heart was removed from the perfusion apparatus and transferred to a micro-CT scanner to obtain unique scans. We conducted apposition analyses of the computational 3D models from micro-CT DICOM datasets, and compared them to the results from direct visualization and commercial OCT's Apposition Indicator software. Additional measurements of resulting coronary anatomic expansions were taken to determine the potential roles of each step in improving procedural outcomes. Micro-CT images show stent deformation during a percutaneous coronary intervention (provisional to Culotte bifurcation procedure) in an isolated diseased human heart.
Keyphrases
- coronary artery disease
- percutaneous coronary intervention
- coronary artery
- contrast enhanced
- optical coherence tomography
- computed tomography
- image quality
- endothelial cells
- dual energy
- st segment elevation myocardial infarction
- atrial fibrillation
- coronary artery bypass grafting
- heart failure
- acute myocardial infarction
- acute coronary syndrome
- st elevation myocardial infarction
- magnetic resonance imaging
- antiplatelet therapy
- pulmonary artery
- cardiovascular events
- minimally invasive
- high resolution
- endovascular treatment
- magnetic resonance
- positron emission tomography
- pluripotent stem cells
- cardiovascular disease
- coronary artery bypass
- healthcare
- deep learning
- diabetic retinopathy
- adipose tissue
- convolutional neural network
- type diabetes
- machine learning
- insulin resistance
- clinical practice
- aortic stenosis
- pet ct
- affordable care act