Real-Time Tracking of Aortic Valve Landmarks Based on 2D-2D Fluoroscopic Image Registration

Transcatheter aortic valve implantation (TAVI) is routinely performed under 2D fluoroscopic guidance. The target position for placement of the stented aortic valve prosthesis is defined by aortic valve landmarks, e.g. coronary ostia. This paper presents a real-time tracking method of these landmarks in 2D fluoroscopic image sequences to improve the positioning of the implant during TAVI. The proposed tracking method is based on the Insight Toolkit (ITK) registration framework. Minimal user-interaction is required to define 2D landmarks in a reference image. The reference image is automatically detected to present all image features, when the aortic root is filled with a contrast agent. Preliminary results showed a good tracking of the landmarks even without the contrast agent in 14 fluoroscopic image sequences.