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Fractional Flow Reserve (FFR) for the Sensis Vibe VD11

This Job Aid provides information about the Fractional Flow Reserve for Sensis Vibe with the software version VD11.

SIEMENS Healthineers FFR Calculation Job Aid Sensis Vibe VD11 Effective Date: 14 October 2020 | HOOD05162003130350 Unrestricted © Siemens Healthineers 2020 FFR and Resting Pd/Pa Calculation SIEMENS Healthineers Table of Contents FFR Calculation 3 FFR Calculation Workflow 6 SIEMENS Note: The product and/or features here mentioned may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. 2 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) SIEMENS Healthineers Purpose: Identify Invasive FFR FFR hemodynamically FFR is done during maximal blood flow, induced by relevant coronary continuous infusion of vasodilating drugs, like e.g. lesions to guide adenosine. coronary revascularization. FFR Effective Date: 14 October 2020 | HOOD05162003130350 3 Calculation Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR Calculation) SIEMENS Healthineers FFR= Fractional Flow Reserve Pa FFR = Distal Coronary Pressure (Pd) max Proximal Coronary Pressure (Pa) Pd (During Maximum Hyperemia) Pd = distal pressure Pa = aortic pressure Pd/Pa + hyperemia = FFR • Fractional flow reserve is defined as the pressure after (distal to) a stenosis relative to the pressure before (proximal to) the stenosis. • FFR is done during maximal blood flow (hyperemia), by injecting vasodilating medication such as Adenosine or Papaverine. FFR Effective Date: 14 October 2020 | HOOD05162003130350 4 Calculation Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Calculation SIEMENS Healthineers A pre-defined setup allows for an automatic FFR and waveform display. During FFR measurement, the distal (Pd) and HR 60 • 18.11.12-15:2. Review Real Tiene 18.11.12-15:27:0 Other 11/18/1858 Calculate Pressures SAN P2_FFR 5 mm/s proximal (Pa) pressure signals are measured 127 / 69 workflow Support 3:33:09 PM dynamics Lesion_Index Pd 60 Current Condition Pa 95 AO LCX AG Hem and the value is calculated from the ratio 0.63 127 / 69 200 200 Pd/Pa. Vital Signs CX 200 180 180 LCX 95 160 160 START Recording 140 140 120 120 Post Processin REC Hemo Calculation 100. 100. • Editing of either calculated value is possible FFR 80 80. 60 60 through the respective Event Properties dialog 40 40 Realtime 1.00 SAI 20 20 box. P.P Tools O O Timer 02:00 View POP. A FFR event can be manually entered for values q Ctrl +Q Events Results Event - • SpO2 95 % Documentation Pre Cath Data Summary Time *** Performing Physicians Resting Pd/Pa | Rest Pd/Pa Value : 0.63 | P1:Pa : [ AO : 95 ] [ mmHg ] | P2 Pd : [ LCX : 60 ] [ mmHg ] | (Pa-Pd) : 35 [ mmHg ] | Duration. 3:34:06 PM" measured by a non-integrated third-party Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| SpO2 : Off [ % ]| Resp : Off [ breaths/min ]| EtCO2 3:27:16 PM Case Times Condition Changed 3:27:15 PM Patient/Procedure Status New Condition| Name : Rest 3:27:15 PM system for final documentation. Procedure Checklist LOC Score Pre Allergies Vital Signs Pre IV/Fluid Status FFR Effective Date: 14 October 2020 | HOOD05162003130350 5 Calculation Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Calculation Workflow SIEMENS Healthineers Preparing the pressure wire system: Pre-configured to use either (P2,P3, or P4) Prior to inserting into the artery, ensure that the Connect the pressure wire system to the HemoBox via pressure wire system is balanced to the the Siemens provided IBP Y-splitter connection. atmospheric pressure (“Zero“) Applications Edit View quire Input Tools Options SENSIS VIBE Review Real Time Zero RCA LAD CX 12345678 1 Other 1 2/1 2/1 950 Equalize Start Rest PdsPa Start FFR Balance Pressure P2_Lesion_L.y 12.5 mm/s Setup Workflow Support Lesion_Index ta Cx Current Condition AO 1. Rest New AO, 200 200 200 CCx -200 B 180 180 Vital Signs P1/P2 ECG 160 160 140 140 START Balance Pressure Transducers 120 120 Post Proces ... |Hemodynam. Recording 4-12 Signals Balancing pressure 100 100 mmHg 80 REC 80 Hemo Calculation P1:AO 60 60 17 40 40 P3/P4 SpO 2 +0+ P2:LCX 55 20 20 O O P3 P4 Tools P./P. 1 Balance Close CO NBP Ctrl + Q Events Results Event: - Pre Cath Data Summary - Time View Performing Physicians Condition Changed 11:26:42 AM Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 11:26:42 AM Case Times Condition Changed 11:05:09 AM Documentation Patient/Procedure Status Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 11:05:09 AM T1/T2 EtCO 2 Procedure Checklist Condition Changed 11:03:04 AM Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 11:03:04 AM Microstream LOC Score Pre Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S .. 11:02:00 AM Allergies Condition Changed 11:01:34 AM Storage: 522:00 Lesion Index Setup Loaded 11:29:12 AM FFR Effective Date: 14 October 2020 | HOOD05162003130350 6 Workflow Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Calculation Workflow SIEMENS Healthineers Place the pressure wire system at the reference Initiate “Equalize“ position, so that the two sensors are reading Accept or Reject → Accept 1 values from same site to prepare for Patient Applications Edit View Acquire Input Tools Options He “Equalization“ TEST Review Real Time Zero RCA LAD CX 123456 Male 09/1 2/1961 Equalize FFR Start Balance Pressure P2_Lesion_I .. Y 12.5 mm/s Setup Workflow Support MHo- 120 120 Lesion_Index ++hi to- RCA Hemodynam .. Current Condition 100 100 1. Rest New Thr To 1200 2000 RCA-200 B 180 180 Vital Signs 80 80 160 160 START 140 140 1.20 120 Post Proces ... 60 60 Recording A AAAMY Equalize Pressures 100 100 80 REC 40 40 Hemo Calculation 60 60 Offset is 0.11 mmHg 40 +0+ AA M 40 20 20 To equalize again, click Reject 20 20 O O SAI P./P. 1 Accept Reject O O Tools Ctrl + Q Events Results 1 Event - Flowsheet Summary - Time View Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:41:42 PM Premedication Condition Changed 2:41:42 PM Indications Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:40:11 PM Documentation Allergies Condition Changed 2:40:11 PM Coagulation Time Coagulation Time | ACT Type:_ | ACT Value (sec): 70 2:20:38 PM Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:20:17 PM Procedure Condition Changed 2:20:17 PM Catheter Allergies | Allergies: Aspirin | Allergy from EMR: | Allergy Code: | Coding .. 2:15:20 PM FFR Workflow Effective Date: 14 October 2020 | HOOD05162003130350 7 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Calculation Workflow SIEMENS Healthineers Inject vasodilating medication and document Initiate “Start FFR“ Labent ApPICa WieW Acquipe Opbons BENSIS VILE LAD CX 12345678 13/1 2/1940 Equalize Start FFR nodynam ... • Recording is started automatically FFR started. 3D4 D REC 2:31:51 PM • Current Pd/Pa value is displayed on LIVE Resting FFR Realtime Pa/P. 1.00 FFR Workflow Effective Date: 14 October 2020 | HOOD05162003130350 8 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Calculation Workflow SIEMENS Healthineers Initiate “Stop FFR“ Applications Edit View Acquire Input Tools Option SENSIS VIBE Review Real Tiene Zero RCA LAD 12345678 Other 1 2/1 2/1950 Calculate Pressures SAI P2_Lesion_Ly 5 mmls Review Real Time Setup Workflow Support TO 2:31:33 PM Lesion_Index Pd 88 Hemodynam. Pa 91 LXD D LADYP Equalize Start Rest Stop FFR Current Condition 1. Rest Now 10.96 + + + + +4 AD P 200 LAD D 200 B 180 Vital Signs 180 160 160 FFR Event Properties 140 st Proces ... 140 General Specific 120 FFR 0196 • Recording is automatically ended FFR 0.96 Bd M 60 60 Duration ( ....... 40 40 (Pa-Pd) 3 mmHg 1 20 20 O 1 Modify or Site • P1.Pa LADP Enter 91 P2Pd LADD Enter 88 Hg • 2 Accept calculated FFR Results Event mary . Time • FFR event created in the CaseLog ng Pd/Pa | Rest Pd/Pa Value : 0.96 | P1:Pa : [ RCAP : 91 ][ mmHg ] | P2:Pd : [ ... 2:26:16 PM out| Original Label : 1. Rest:RESTING_PD_PA | Original Time : 2:26:11 PM |E. 2:26:10 PM ition Changed 11:26:42 AM Everits Results Event 2 Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 11:26:42 AM ition Changed 11:05:09 AM Summary - Time Print Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S .. 11:05:09 AM ition Changed 11:03:04 AM FFR | FFR : 0.96 |P1;Pa: [ LAD P : 91 ] [ mmHg ][ P2 Pd : [ LAD D : 88][ mmHg ] | 2:32:12 PM OK Cancel Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 11:03:04 AM Printout| Original Label : 1. Rest.FFR | Original Time : 2:31:33 PM | Event Offset : 0 2:31:33 PM Storage: 521:56 2:31:33 PM - FFR 2:32:29 PM Resting Pd/Pa | Rest Pd/Pa Value : 0.98 | P1:Pa: [ RCAP : 91 ][ mmHg ] | P2.Pd :| 2:26:16 PM Resting P.P. Resting Pd/Pa or FFR value is displayed FFR 0.96 • on LIVE Realtime 1.00 P.P. Timer 01:07 FFR Workflow Effective Date: 14 October 2020 | HOOD05162003130350 9 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR) Workflow SIEMENS Healthineers Manually adding FFR values from another 1 source Acquire Input Tools Options 02 Saturation 1 Review ummary Time Cardiac Output anual Resting Pd/Pa | Rest Pd/Pa Value : 0.87 | P1:Pa : _ | P2:Pd : 3:04:08 PM Select FFR from the Input Menu HB. 02 Consumption 2 • The event is created in the CaseLog Vital Signs FFR 2 10 Manual Resting Pd/Pa Event Properties x Condition General | Specific Click on “Enter Site“ for setting the Pa and Site Normal Congenital Pd Coronary Site Peripheral Not Defined • The Site dialog opens, choose the P1:Pa Enter Site P2:P Enter Site site from the Site Tree Click Okay 2 • • The event is updated in the CaseLog Print OK Cancel OK Cance FFR Effective Date: 14 October 2020 | HOOD05162003130350 10 Workflow Unrestricted © Siemens Healthineers, 2020 SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthineers Global Siemens Healthineers Headquarters Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84 siemens.com/healthineers Effective Date: 14 October 2020 | HOOD05162003130350 11 Unrestricted © Siemens Healthineers, 2020

  • sensis
  • vibe
  • fractional flow reserve
  • ffr
  • vd11
  • cardiology
  • workflow