Hybrid cath lab solutionsCreating new therapeutic opportunities in interventional cardiology

www.siemens.com/healthcare

As invasive procedures such as aortic valve

replacements, mitral valve repairs, and epicardial

ablations of ventricular tachycardias enter the

field of interventional cardiology, medical

institutions are increasingly exploring the

possibility of installing a hybrid catheterization

lab. By fulfilling the requirements of advanced

imaging and an operating room, next-generation

cath labs are ideally suited for performing new

therapeutic procedures. They also help to improve

the quality and cost-effectiveness of patient

care by expanding your room capabilities and

broadening your procedure mix.

Designing and installing a hybrid cath lab spe-

cifically customized to your needs – current and

future – requires a dedicated team of experts.

Siemens has extensive cardiology expertise and

experience. With its forward-oriented Artis zee

family of imaging systems and advanced applica-

tions, it also possesses one of the most progressive

cath lab solution portfolios on the market today.

Expanding the capabilities of your cath lab

A. Vahanian et al., “Transcatheter valve implantation for patients withaortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC),” Eur J Cardiothorac Surg (2008), doi:10.1016/j.ejcts.2008.04.039

The optimal environment for TAVI should be spacious and sterile, and feature high-quality imaging equipment. A hybrid suite is ideal as it fulfills the role of both an oper ating room and a catheterization laboratory. Howev-er, most institutions do not have a hybrid room available, thus the organizational and financial implications of acquir-

ing one, which is highly desirable, cannot be overlooked.

3

Aortic valve implants with enhanced guidanceAlthough 2D fluoroscopy continues to be the gold standard in interventional

cardiology, it has limitations. Advanced 3D imaging tools can significantly

enhance planning and guidance during valve deployment.

syngo DynaCT Cardiac image of the aortic root

syngo DynaCT Cardiac

After a 5-second rotational angiography run with a maximum of

25 ml contrast agent the special syngo DynaCT Cardiac recon-

struction algorithms create CT-like images of the aortic root and

its surrounding structures. The anatomical information provided

by the 3D visualization of the aortic root and the ascending aorta

can assist physicians in planning the valve implantation.

Segmentation of the aortic root, including anatomical

landmarks

syngo Aortic ValveGuide*

Starting with syngo DynaCT Cardiac images as the basis,

syngo Aortic ValveGuide achieves a whole new level of valve

positioning convenience. The software provides a segmentation

of the aortic root that indicates the ideal perpendicular projec-

tion for valve deployment, along with landmarks – completely

automatically, in less than 10 seconds. The C-arm projection can

be synchronized with the 3D view, thereby saving time and dose

as compared to fluoroscopy guidance alone.

3D guidance during valve deployment with

syngo iPilot

syngo iPilot

By simultaneously displaying the live fluoro image and matching

syngo Aortic ValveGuide segmentation result, syngo iPilot creates a

2D/3D overlay to facilitate valve positioning before inflation.

Accurate and precise positioning of the valve can be confirmed

with a new 3D image and overlay.

* Work in progress. The information about this product is preliminary. The product is under development and not commercially available in the U.S., and its future availability cannot be ensured.4

Imaging Excellence

Cardiac resynchronizationtherapy with less contrast mediaBiventricular lead placements are regarded as challenging interventions.

Angiographic coronary sinus (CS) visualizations generally require lots of

contrast media and fluoroscopy. 3D visualizations of the coronary sinus can

facilitate lead placements as well as decrease procedure time.

2D/3D overlay of the live fluoroscopy and segment-ed coronary sinus to guide the lead implantation

Rotational angiography of the coronary veins with syngo DynaCT Cardiac

Segmented coronary sinus with blue C-arm in upper right hand corner showing actual projection

Integrating a 3D reconstruction with the real-time fluoroscopy

image, syngo iPilot supports very efficient guidance during

the implantation of the transvenous pacing leads into the target

vein. No additional contrast injections are needed to visualize

the CS. During the procedure, projection changes are dynami-

cally adapted.

syngo iPilot

This application uses a syngo DynaCT Cardiac run and less than

30 ml contrast agent to create a 3D reconstruction of the coro-

nary veins – during the procedure. An inflated balloon is used

to occlude the coronary sinus. The high-resolution imaging

of syngo DynaCT Cardiac can also assist with critical decisions,

for example, whether interventional treatment or open-heart

surgery is the best option.

syngo DynaCT Cardiac

Anatomical characteristics are clearly revealed through the

segmentation of the coronary sinus with syngo InSpace 3D.

By synchronizing the C-arm angulation and rotation with the

3D segmentation, the application helps to find the optimal

projection – without the need for additional contrast media

and fluoroscopy.

syngo InSpace 3D

For more information, visit us at www.siemens.com/hybrid-cathlab

5

Artis zee Cockpit

Featuring a 30’’ medical-grade monitor, the Artis zee

Cockpit can display up to six sources on one screen –

simultaneously. Screen layouts can be changed with

a simple mouse click. The unique drag & drop func-

tionality lets you easily rearrange image scans to

display clinical data the way you like it.

A floor-mounted imaging system such as Artis zeego offers clear

advantages in meeting a hybrid room’s high sterility standards.

The ceiling over the sterile OR field is kept free from system compo-

nents, which could interfere with surgical lights or laminar airflow.

The system enables highly flexible positioning around the patient.

In the park position, the C-arm is completely out of the way for easy

patient access.

Artis zeego – dedicated imaging for hybrid procedures

• Unique positioning capabilities

• Ergonomic design with flexible working height and variable isocenter

• Integrated table with tilt, cradle and synchronized tracking

• Innovative 3D imaging capabilities with syngo DynaCT Cardiac

• Ideally suited for institutions interested in conducting new interventional treatments

• Innovative 3D imaging capabilities with syngo DynaCT Cardiac

6

Hybrid starts with high-end imaging

Equipped with advanced imaging technolo-gy, a hybrid cath lab can provide exceptional flexibility and support for a wide range of cardiovascular procedures, structural heart diseases as well as cardiac resynchronization therapy. Artis zee solutions for hybrid cath- labs are designed to make your workflow smart, easy and efficient.

Tableside control

Artis zee systems feature a new user interface with a compact design as well as easy-to-read syngo icons for quick task card selection. Customized workflow setups and integrated mouse control offer additional operating con-venience.

Intraprocedural 3D imaging

Complex interventions such as valvular disease therapies can benefit from additional anatomi-cal information provided by advanced 3D imag-ing. Artis zee systems incorporate enhanced syngo imaging applications such as reconstruc-tion, segmentation and landmarks of 3D struc-tures acquired during the intervention.

7

Integrated interventional table with OR capabilities

Interventional cardiologists and surgeons

have different table requirements. Siemens

has developed an integrated OR table that

supports high-end imaging applications. The

table features motorized vertical and lateral

tilt movements for invasive interventions as

well as a four way floating tabletop.

Artis zee Large Display

Featuring a 56-inch medical-grade screen

and 8-megapixel image resolution, the

Artis zee Large Display provides customized

clinical images and information on one

screen – with up to 21 video source inputs.

It can also be used to monitor other rooms

and to support telemedicine, endoscopy

and ultrasound applications.

8

Artis zee biplane system – first choice for pediatrics

• Second isocentric working position provides full patient coverage from head to toe

• Unique left side position gives anesthesiologist generous access to the patient’s head

• Ideally suited for treating patients particularly vulnerable to the effects of contrast media, e.g. pediatric patients

Artis zee floor-mounted system – the compact solution

• With its extra small footprint, this system fits into virtually any cath lab

• System movements do not interfere with the laminar flow or pass over the sterile field

• MultispaceF and rotatable integrated OR table enable unique positioning flexibility for a conventional floor- mounted system

• 3D imaging capabilities of syngo DynaCT Cardiac support complex structural interventions

• Ideally suited for reducing the risk of contamination- related infections in the surgical environment

Artis zee ceiling-mounted system – the flexible all rounder

• C-arm and flat detector positioning flexibility allows imaging from all angles around the patient while maintain- ing the anatomical orientation of the displayed images

• InFocus and Isotilt uphold the projection on the region of interest during gantry movements and integrated OR table tilting

• syngo DynaCT acquisition from left/right side allows 3D imaging of peripheral regions

• Ideally suited for cath labs with high percentage of peripheral cases

9

Enhanced Workflow

Hybrid starts with high-end imaging

Equipped with advanced imaging technology, a

hybrid cath lab can provide exceptional flexibility

and support for a wide range of cardiovascular

procedures, structural heart diseases as well as

cardiac resynchronization therapy. Artis zee solu-

tions for hybrid cath labs are designed to make

your workflow smart, easy and efficient.

Preparation areaStorage Equipment

Control room

Cath lab

850

850

At Siemens, hybrid cath lab competence extends far beyond simply

installing imaging systems. Our dedicated team of experts will work

closely with you in designing a suite customized precisely to your

needs – everything from the room planning to the setup and imple-

mentation, including the selection of an appropriate imaging sys-

tem and applications, monitor booms, anesthesia equipment and

surgical lighting.

Specializing in user-centric cath lab designs

Our planning experts design roomlayouts to optimally support workflow

One-stop hybrid expertise – Siemens turnkey hybrid solutions cover:

• All construction and/or renovationservices of healthcare facilities

• Everything from consulting to plan-ning, implementation and partnership

• Multi-vendor product compatibilityand coordination

10

Planning

When designing a hybrid cath lab, two factors are particularly important: space requirements and the intended use of the room. Ideally, the room should offer maximum flexibility for handling a wide range of cardiovascular applications as well as fulfill your therapeutic needs over the long term. It should be

equipped with advanced imaging capabilities that support minimally invasive coronary interventions at low dose as well as create an OR environment that supports cardiac device implants for treating structural heart disease and rhythm disorders.

11

Compared with a conventional cath lab, the added expenditures

for a hybrid room setup appear considerable. However, a hybrid

cath lab can position a hospital as an innovative healthcare provider,

one that offers a higher level of care.

The higher investment is also justified by the potential for new treatment opportunities and additional patients. For example, percutaneous valve implantations offer an alterna-tive for high-risk patients previously considered untreatable. In addition, a hybrid environ-ment allows emergency surgical intervention in the event of complications.

As a leading provider of advanced cath lab and surgical suite solutions, Siemens hasextensive experience in designing and furnishing customized hybrid rooms.

At the forefront of developments in cardiology

Cardio-Thoracic Center, Monaco COROSKOP

1990

Heart Center, Leipzig, GermanyAXIOM Artis dTA

2004

German Heart Center, Munich, GermanyAXIOM Artis dFC

2007

Today more than 300

hybrid suites worldwide

installed by Siemens.

Investment Confidence

NewYork - Presbyterian, New York, NY, USA Artis zeego

2009

UCL Saint Luc, Brussels, BelgiumArtis zeego

2008

Siemens helped us plan and set it up. An Artis zeego forms the centerpiece of our new hybrid room, which gives us tremendous treatment flexibility.

Dr. Bernard De Bruyne, Head of Cardiology, Cardiovascular Centre Aalst,

Belgium

13

On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice.

Some/All of the features and products described herein may not be available in the United States or other countries.The information in this document contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases.

Siemens reserves the right to modify the design, packaging, specifications and options described herein without prior notice. Please contact your local Siemens sales representative for the most current information.

Original images always lose a certain amount of detail when reproduced. In the interest of complying with legal requirements concerning the environ-mental compatibility of our products (protection of natural resources and waste conservation), we recycle certain components.

Using the same extensive quality assurance measures as for factory-new components, we guarantee the quality of these recycled components.

Note: Any technical data contained in this document may vary within defined tolerances. Original images always lose a certain amount of detail when reproduced.

For accessories, go to:www.siemens.com/medical-accessories

Not for distribution in the U.S.

Order No. A91AX-11004-11C2-7600 | Printed in Germany | CC AX 11101. | © Siemens Healthcare GmbH, 2016

siemens.com/healthcare

Siemens Healthcare Headquarters

Siemens Healthcare GmbHHenkestr. 12791052 ErlangenGermanyPhone: +49 9131 84-0siemens.com/healthcare