Protocol Number: 09-H-0211

Title:

X-ray Fluoroscopy Fused with Computed Tomography (XFC) Technical Development

Number:

09-H-0211

Summary:

Background:

- Computed tomography (CT) creates three-dimensional images based on X-ray imaging. CT is useful for determining treatment approaches for certain diseases, such as calcific aortic stenosis (narrowing of the aorta because of calcium deposits).

- Comparing the data received from CT scans with the data received from heart catheterization (which assesses the heart's condition and function) can be used to improve treatment in patients with certain heart conditions. Researchers are interested in looking at the effectiveness of both procedures in assessing possible surgical treatments for patients with calcific aortic stenosis.

Objectives:

- To analyze cardiac CT scans in conjunction with existing heart scan results to improve treatments for future minimally invasive aortic valve replacement.

Eligibility:

- Patients 18 years of age and older who have been diagnosed with aortic valve stenosis that may be treated surgically, and who will undergo or have recently undergone heart catheterization.

Design:

- Participants will have a CT scan within 90 days of the medically necessary heart catheterization, but before any other surgical or catheter treatment.

- During the CT scan, patients will be asked to hold their breath intermittently for about 5 to 20 seconds. Patients will be inside the scanner for less than 30 minutes.

- Patients will be asked to return in 3 to 7 days for a blood test to check kidney function.

- Researchers will analyze the results of the CT scan in conjunction with the previous results from the catheterization to determine possible improved treatment options.

Sponsoring Institute:

National Heart, Lung and Blood Institute (NHLBI)

Recruitment Detail

Type: Participants currently recruited/enrolled

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA:

SELECTION CRITERIA: PATHWAY FOR RESEARCH CT:

-Adult patients age 18 years or older

-Having calcific aortic stenosis being considered for surgical or catheter-based treatment, determined on physical examination or noninvasive imaging such as echocardiography

-Undergoing diagnostic cardiac catheterization within 1 year

-Able to provide informed consent

ALTERNATIVE SELECTION CRITERIA: PATHWAY FOR ANALYSIS OF MEDICAL DATA:

-Adult patients age 18 years or older

-Having calcific aortic stenosis being considered for surgical or catheter-based treatment, determined on physical examination or noninvasive imaging such as echocardiography

-Undergoing diagnostic cardiac catheterization within 1 year

-Having undergone cardiac CT for medical indications meeting the technical requirements of this protocol

-Able to provide informed consent

EXCLUSION CRITERIA:

SELECTION CRITERIA: PATHWAY FOR RESEARCH CT:

-Pregnant or lactating women

-Decompensated heart failure (unable to lie flat during CT)

EXCLUSION CRITERIA FOR BETA ADRENERGIC BLOCKERS:

-Advanced atrioventricular block (Mobitz Type II second degree or third degree atrioventricular heart block)

-Asthma or chronic obstructive pulmonary disease (emphysema) currently treated with beta adrenergic agonists

EXCLUSION CRITERIA FOR IODINATED RADIOCONTRAST:

-Severe kidney disease (MDRD estimated Glomerular Filtration Rate

< 30mL/min/l.73m(2)).

-Request of referring physician or surgeon not to administer iodinated radiocontrast

ALTERNATIVE SELECTION CRITERIA: PATHWAY FOR ANALYSIS OF MEDICAL DATA:

-None

Special Instructions:

Currently Not Provided

Keywords:

Cardiac CT

Iodinated Radiocontrast

Ionizing Radiation

Aortic Valve Stenosis

Percutaneous Aortic Valve Replacement

Recruitment Keyword(s):

Heart Valve

Aortic Valve Stenosis

Condition(s):

Aortic Valve Stenosis

Investigational Drug(s):

None

Investigational Device(s):

None

Intervention(s):

None

Supporting Site:

National Heart, Lung, and Blood Institute

Contact(s):

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):

GutiŽrrez LF, Silva R, Ozturk C, Sonmez M, Stine AM, Raval AN, Raman VK, Sachdev V, Aviles RJ, Waclawiw MA, McVeigh ER, Lederman RJ. Technology preview: X-ray fused with magnetic resonance during invasive cardiovascular procedures. Catheter Cardiovasc Interv. 2007 Nov 15;70(6):773-82

Zajarias A, Cribier AG. Outcomes and safety of percutaneous aortic valve replacement. J Am Coll Cardiol. 2009 May 19;53(20):1829-36

Khot UN, Novaro GM, Popovi? ZB, Mills RM, Thomas JD, Tuzcu EM, Hammer D, Nissen SE, Francis GS. Nitroprusside in critically ill patients with left ventricular dysfunction and aortic stenosis. N Engl J Med. 2003 May 1;348(18):1756-63

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