Transcatheter mitral valve replacement (TMVR), a minimally invasive surgery to replace a damaged mitral valve, can help patients with severe mitral valve issues without the need for open-heart surgery. Stanford Medicine surgeons use advanced imaging from the to personalize a TMVR procedure to their patient鈥檚 needs.

Cardiothoracic surgeon John W. MacArthur, MD, assistant professor of cardiothoracic surgery, and interventional cardiologist Rahul P. Sharma, MBBS, FRACP, clinical associate professor of cardiovascular medicine and director of Structural Interventions at 糖心传媒, collaborated with 3DQ Lab on a patient evaluation. The patient had symptoms of fatigue, shortness of breath, and palpitations. 3D imaging showed the patient had a severely calcified mitral valve, which commonly causes mitral regurgitation.

鈥�3DQ Lab鈥檚 imaging gave us the additional data we needed to accurately diagnose our patient鈥檚 condition,鈥� said Dr. MacArthur. 鈥淔rom there, we continued to partner with the lab to figure out the next care steps.鈥�

To determine whether the patient was a good candidate for TMVR, a 3DQ Lab technologist performed a cardiac-gated CT angiogram of the patient鈥檚 abdomen, chest, and pelvis with contrast to observe blood flow. The cardiac gating synchronized images with specific phases of the patient鈥檚 cardiac cycle.

For instance, the 4D view of the patient鈥檚 mitral valve gave physicians a comprehensive view of the valve in motion, helping them see its structure and function. A 4D video also showed the valve鈥檚 opening and closing movements throughout the cycle, allowing physicians to detect calcium buildup and other irregularities, such as regurgitation.

鈥淒ue to the patient鈥檚 extensive heart calcifications, 3DQ Lab provided imaging and measurements for two different valve devices, the Intrepid valve and the SAPIEN valve,鈥� said Dr. Sharma. 鈥淭hese measurements helped our team determine the best type and size valve for our patient, based on their anatomical requirements.鈥�

Additionally, the lab provided a view of the patient鈥檚 venous delivery pathway to help determine the catheter鈥檚 path during the TMVR procedure. Measurements also showed different valve positioning scenarios that helped the team predict what placement might result in the best functioning post-procedure.

Stanford Medicine radiologists supervise the lab work at 3DQ Lab to ensure the highest quality imaging support for interventional procedures and help translate imaging data into actionable insights. In particular,听 Brian Patrick Pogatchnik, MD, clinical assistant professor of radiology, helped build up the lab鈥檚 ability to provide TMVR services and oversees workflow for these procedures.

The collaboration with 3DQ Lab runs across departments and specialties, including , , , , and . This teamwork provides a comprehensive approach to moving patient care forward through expertise and innovation.

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