ABSTRACT
INTRODUCTION Image-guided, minimally invasive procedures have steadily grown in importance for the treatment of cardiovascular diseases. Increasingly complex interventional procedures are challenging many treatments that used to be within the realm of both, cardiac and thoracic surgery. During these procedures, instruments such as needles, catheters, stents, and stent grafts are inserted into the human body under image guidance. Not only the procedures but also the imaging modalities, which are used to control and monitor these procedures have become technically more complex. In the past, X-ray image guidance was the stronghold for cardiovascular image guidance. The main advantage of X-ray fluoroscopy is real-time imaging with image acquisition and display rates of 10 or more frames per second. However, X-ray-based imaging techniques do utilize ionizing radiation and the lack of soft-tissue contrast limits their applicability in complex anatomical sites. Therefore, methods such as intravascular ultrasound (IVUS) and fusion of preacquired computed tomography (CT) and magnetic resonance (MR) images with fluoroscopy have been increasingly applied during cardiovascular interventions to add information that is essential to perform challenging interventional procedures.
