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With this next video, we're gonna talk about fluoroscopic C-arm, uh,

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measurements. What these are,

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are you're actually trying to give the operator the, um,

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interventional cardiologist and the surgeon who are working on this case a good

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starting point for optimal viewing of the aortic valve orientation during the

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procedure. So I'm using some, uh,

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specialized three D software here. Again, any of the three d um,

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packages that you can get for assisting with TAVR measurements will

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give an approach to doing these types of measurements.

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They're all a little bit different, but conceptually they all, you know,

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do the same thing. And so I'm just gonna show you how it's done.

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This particular software package,

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we started by identifying the basal plane by

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placing markers at the bottom of the right,

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left and non coronary cusps.

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And so you can see those markers have colors assigned to them, uh, green, red,

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and yellow. So each color is the bottom of the cusps.

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And so now if you look at this virtual fluoroscopic image,

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you can see the different markers, right?

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And the goal here is you'd like to have the markers coplanar and

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evenly spaced. And so what you want to do,

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and usually the software does this for you, but I honestly,

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I kind of like made it a little bit cockeyed just to demonstrate,

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lemme scroll down actually to the annular plane here.

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And what you want to do is you want to get all those markers,

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co-planner just like that.

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And within the more right sided versus more left sided,

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you want to adjust them to make sure that they're even, so for instance,

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here I've got the green and the yellow really close together,

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and the red further away,

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I wanna put the green in the middle and the red and the yellow, um,

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at either end.

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So they're equally spaced in this plane and that they're all in the

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same plane, sort of in this coronal view here. And then once you have that look,

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this is really the optimal look for them when they're placing the device,

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when they're doing a fluoroscopic evaluation.

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This helps 'em really see the device end on.

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And the nice thing is that we can tell 'em the optimal measurements and they're

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displayed right here, l a o six and cranial two degrees.

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So those are the optimal fluoroscopic measurements that will report to assist

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the cardiologist when performing the case.