Safety and feasibility of novel technology fusing echocardiography and fluoroscopy images during MitraClip interventions

Aims: The EchoNavigator (EN) software (Philips Healthcare, Best, The Netherlands) enables real-time fusion of echocardiography and fluoroscopy by co-registration of the echocardiography probe on the x-ray image. We aimed to evaluate the feasibility and safety of this novel software during MitraClip procedures. Methods and results: Twenty-one patients were treated with the support of EchoNavigator software (EN+ patients). The primary (safety) endpoint was the total radiation dose. Secondary endpoints were fluoroscopy and total procedure time. The measurements were compared to those of 21 patients treated immediately before the installation of EchoNavigator (EN-patients). More MitraClips (45 vs. 36) were implanted in the EN+ group, mirroring more complex interventions in this group. In EN+ patients, radiation dose (Gy/cm(2)) was similar compared to EN-patients (146.5 +/- 123.6 vs. 146.8 +/- 134.1, p=0.9). Total procedure time (minutes) was similar in the EN+ group compared to EN-patients (136.2 +/- 50.2 vs. 125.7 +/- 51.2, p=0.5). The main benefit of the EchoNavigator is the automated real-time fusion of echocardiography and fluoroscopy, leading to easier catheter manipulation. Conclusions: The use of EchoNavigator software was feasible and safe in all study patients. Further studies are necessary to confirm the benefits of using this software.