Improving Clinical Assessment and Workflow

The company's Axius Velocity Vector Imaging™ (VVI) technology offers clinicians a new way to assess the heart's contraction mechanics using ultrasound information to visualize contraction and relaxation mechanics, with the ability to see a "freeze frame" of motion at any point in the cardiac cycle.

Early adopters report this promising new technology provides unique insight into ventricular mechanics and is helpful in evaluating patients with hypertrophic cardiomyopathy, as well as candidates for biventricular pacing.

In addition, Siemens' Axius Auto Ejection Fraction™ technology, which automatically calculates Ejection Fraction without the need for operator interaction, helps to enhance accuracy and workflow by automatically detecting and calculating the most common cardiac function parameters using proprietary pattern recognition technology.

"The addition of VVI technology is a promising new method to quantify the dyssynchrony or mechanics of the failing heart," said John Gorcsan, M.D., professor of medicine and director of echocardiography, University of Pittsburgh.

"In a pilot study of approximately 25 patients, we found we could successfully measure dyssynchrony in heart failure patients referred for cardiac resynchronization therapy (CRT) with echocardiography.

Additionally, VVI has the advantage that it can be applied to routine gray scale images off-line, so it may be complementary to the tissue Doppler approach."

Dr. Gorcsan also finds the Auto EF technology to require less time than manual EF and shows strong clinical potential.

"The objective of Auto EF technology is to provide a solution for every patient to meet the demands of EF measurements in adult cardiology," said Arnd Kaldowski, vice president, global sales and marketing, Ultrasound Division, Siemens Medical Solutions.

"We have taken a radical new approach on the Sequoia system with Auto EF by developing a CAD technology, similar in purpose to the approach used in automated ECG diagnostics.

As a result, an expert system database has been formed from over 1,000 studies, which is then used to teach the computer how to 'recognize' left ventricular function in both apical four-chamber and two-chamber views, and estimate where the expert tracer would have outlined the LV on an echo image clip."

As a result, Axius Auto EF technology helps reduce observer variability by bringing expert-level interpretation to every exam. Clinical diagnoses and support are more accurate and exam time is shortened.

Breakthrough Fetal Stent Placement Procedure

Carol Benson, M.D., director of ultrasound and co-director of high-risk obstetrical ultrasound, Brigham and Women's Hospital, and a key member of the team performing this first-of-its-kind procedure, used the Sequoia system to guide the catheter through the mother's abdomen and uterus into the heart of the fetus.

A fine needle, followed by a wire with a pre-loaded balloon was gently pushed into the left atrium and through the atrial septum to deflate the high pressures causing the atrium to distend with the blocked blood flow.

"The balloon was inflated until the first atrial septal defect (ASD) was created," said Dr. Benson. "Then we used the same process to create a second hole in the septum to place a stent into this new ASD.

We followed all of this on the Sequoia monitor to guide position for the stent and ensure blood flow through the stent, which showed up immediately. The system has the resolution, functionally, as well as the probes we need to perform such delicate cardiac interventions."

During the echocardiography exam prior to full gestation, the fetus appeared to be in the classic HLHS category instead of the highest risk category due to the fact that the septum stayed intact. Today, the baby has undergone the first stage of the HLHS surgical repair and the reports are good.

"HLHS is the number one cause of neonatal mortality from congenital heart disease," said Dr. Benson.

"After performing this successful procedure, I'm confident we can perform more with positive results because of the resolution and sensitivity in our ultrasound technology for catheter guidance."

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