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首页> 美国卫生研究院文献>Cardiovascular Diagnosis and Therapy >Advanced 3-D analysis client-server systems and cloud computing—Integration of cardiovascular imaging data into clinical workflows of transcatheter aortic valve replacement
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Advanced 3-D analysis client-server systems and cloud computing—Integration of cardiovascular imaging data into clinical workflows of transcatheter aortic valve replacement

机译：先进的3-D分析客户端-服务器系统和云计算-将心血管成像数据集成到经导管主动脉瓣置换的临床工作流程中

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Degenerative aortic stenosis is highly prevalent in the aging populations of industrialized countries and is associated with poor prognosis. Surgical valve replacement has been the only established treatment with documented improvement of long-term outcome. However, many of the older patients with aortic stenosis (AS) are high-risk or ineligible for surgery. For these patients, transcatheter aortic valve replacement (TAVR) has emerged as a treatment alternative.The TAVR procedure is characterized by a lack of visualization of the operative field. Therefore, pre- and intra-procedural imaging is critical for patient selection, pre-procedural planning, and intra-operative decision-making. Incremental to conventional angiography and 2-D echocardiography, multidetector computed tomography (CT) has assumed an important role before TAVR. The analysis of 3-D CT data requires extensive post-processing during direct interaction with the dataset, using advance analysis software.Organization and storage of the data according to complex clinical workflows and sharing of image information have become a critical part of these novel treatment approaches. Optimally, the data are integrated into a comprehensive image data file accessible to multiple groups of practitioners across the hospital. This creates new challenges for data management requiring a complex IT infrastructure, spanning across multiple locations, but is increasingly achieved with client-server solutions and private cloud technology.This article describes the challenges and opportunities created by the increased amount of patient-specific imaging data in the context of TAVR.
机译：退化性主动脉瓣狭窄在工业化国家的老龄化人口中非常普遍，并与预后不良有关。手术瓣膜置换术是唯一公认的长期疗效改善的治疗方法。但是，许多年龄较大的主动脉瓣狭窄（AS）患者高危或不适合手术。对于这些患者，经导管主动脉瓣置换术（TAVR）已成为一种治疗选择。TAVR手术的特点是缺乏手术视野的可视化。因此，术前和术中成像对于患者选择，术前计划和术中决策至关重要。与传统的血管造影和二维超声心动图相比，多探测器计算机断层扫描（CT）在TAVR之前已发挥了重要作用。 3-D CT数据的分析需要使用高级分析软件在与数据集直接交互期间进行大量的后处理。根据复杂的临床工作流程对数据进行组织和存储以及图像信息的共享已成为这些新颖治疗方法的关键部分方法。最佳地，将数据集成到一个全面的图像数据文件中，整个医院的多组从业人员均可访问。这给需要跨多个位置的复杂IT基础架构的数据管理带来了新的挑战，但是通过客户端-服务器解决方案和私有云技术越来越多地解决了这一问题。本文介绍了因患者而异的成像数据量不断增加所带来的挑战和机遇在TAVR的背景下。

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