Image guidance of percutaneous coronary and structural heart disease interventions using a computed tomography and fluoroscopy integration

Standard angiography (SA) of the coronary vasculature and heart structures is limited by its two-dimensional (2-D) projection of complex three-dimensional (3-D) structures. The use of angiography and fluoroscopy results in imaging artifacts and procedural limitations that makes some interventions difficult. The introduction of 3-D imaging technologies paves the way to a more precise and thorough evaluation of complex structures. Computerized tomographic angiography (CTA) and X-ray based innovative 3-D reconstruction fusion software are major advances in cardiovascular imaging. These imaging techniques provide a 3-D vessel representation and enable the subsequent analysis of 3-D properties with important clinical implications. This review will focus on novel X-ray/CT image fusion techniques that allow for guidance of percutaneous coronary and structural heart disease interventions off- and online.