1. Page 1IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Hybrid Operating Room IASI, 2009 Dominique SchwarzSiemens Healthcare

2. Page 2IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 The latest trend in cardiovascular surgery is the development of hybrid treatment strategies for any given set of cardiovascular lesions. Percutaneous Aortic Valve Implantation Thoracic Aortic Surgery and Stenting Hybrid Coronary Revascularization Latest trend

3. Page 3IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Hybrid procedures are the combination of minimally invasive surgery with endoluminal techniques arranged in one setting. The aim of hybrid procedures are To minimize procedural and patient risk To optimize success rates To enhance complication management To advance workflow efficiency Hybrid procedures

4. Page 4IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 A Hybrid Operation Room is a special constructed environment that meets the requirements for interdisciplinary work to provide the best out of two worlds for the patients demands. A Hybrid Operation Room stands for the combination of imaging equipment in an sterile operating theatre. Hybrid operation rooms

5. Page 5IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 The modality of choice is a fix-mounted, powerful Angiography System with excellent and reliable Image Quality and 3D-imaging capabilities. Modality of choice

6. Page 6IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 provides: Unlimited patient access for everyone in the room High-grade flexibility for no interference Floor-mounted device to meet hygenic requirements Left and right imaging positions and full body coverage Various parking positions when imaging is not needed Artis Zeego

7. Page 7IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 With a variety of integrated table solutions a hybrid room serves as traditional imaging lab as well as traditional operating theatre at the same time without any limitations to each other. Integrated table solutions

8. Page 8IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Integrated workflow solutions tailored to dedicated hybrid procedures based on minimized user interaction and automated segmentation and measurement tools support surgeons and interventionalists during hybrid procedures. Workflow solutions DynaCT Imaging Segmentation Measurement Flouro Overlay

9. Page 9IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 3D DynaCT imaging directely in the Hybrid OR enables pre- and postoperative evaluation and guidance during device placement. 3D Imaging solutions

10. Page 10IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 We gained experience with > 170 Hybrid-OR installations worldwide in the past two years. Artis Zeego is the dominating Imaging system in Hybrid ORs with 42% in 2009. Experience biplane 10% mobile 13% floor8% ceiling28% zeego 42% Cardiac surgery Vascular surgery Neuro surger Others (abd., exper.)

11. Page 11IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 With excellent clinical / industrial partnerships we can support innovations and simultaneously keep pace with rapid medical and technical developments to achieve better outcomes. thinking hybrid Partnership

12. Page 12IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Congratulations ! to your Hybrid-OR and Good Luck ! for your cardiovascular program

13. Page 13IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89

14. Page 14IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89

15. Page 15IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 DynaCT workflow im Hybrid-OP Real-time overlay und Guidance Sapiens Edwards Core valve Ventor Embracer Aortenklappen Implantate

16. Page 16IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Thorakale Aorta durch retrograde oder antegrade Stentimplantation mit oder ohne Aortenbogenrekonstruktion oder Gefässtransposition Thorako-abdomineller Übergang Roberto Chiesa, MD et. Al. J Vasc Surg. 2007 Jun;45(6):1128-35 3D-Bildgebung (Dyna-CT) im Hybrid-Raum

17. Page 17IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Hybrid Koronarrevaskularisation

18. Page 18IASI, October 2009Dominique Schwarz 11,20 8,80 5,5,1 4,4 1,2 1,6 8,0 8,6 11,60 6,71 11,89 Modern hybrid coronary revascularization refers to a 1-stop CABG/PCI in a hybrid room in 1 setting, and is based on the excellent results on LIMA- LAD grafts and DES PCI in non-LAD vessels.