ACUSON Origin Z6T Transesophageal Transducer (TEE) Presentation

SIEMENS Healthineers SIEMENS Healthineers .. ACUSON Origin Ultrasound System Z6T Transesophageal Transducer 1.0 software version 1 Unrestricted © Siemens Healthineers 2023 Speaker Notes The purpose of this presentation is to review the Z6T transesophageal transducer on the ACUSON Origin ultrasound system. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS. Healthineers .. • Discuss Z6T design and imaging features • Review care and cleaning 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes We will begin by discussing design and imaging features of the Z6T. Notes No. 2 SIEMENS Healthineers Z6T transducer design SIEMENS . Healthineers ... • Leverages success of the Z6Ms for diagnostic imaging and interventional guidance while increasing imaging performance • Supports 2D and 4D B-mode, 2D and 4D color Doppler, and Spectral Doppler • Bi-plane+ imaging 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes The Z6T leverages the success of its predecessor, the Z6Ms, for diagnostic imaging and interventional guidance with increased imaging performance. It supports 2D and 4D B-mode, color Doppler, and Spectral Doppler as well as Bi-plane+ imaging. Notes No. 3 SIEMENS Healthineers Z6T transducer design SIEMENS . Healthineers ... Design changes incorporated based on customer use testing: • A/P control located on bottom and is larger since it is used more • L/R control located on top and smaller in size • Increased separation between the controls allows users to control each individually without accidental movement of the other control • Curved edge design of controls follows the shape of users’ hands/fingers more naturally • Friction brakes are also located on the handle for both flexion controls 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes Design evaluations were performed with feedback from users. Based on that feedback the following changes were made to the controls on the handle: • A/P control is located on bottom and is larger since it is used more • L/R control is located on top and smaller in size • Increased separation between the controls allows users to control each individually without accidental movement of the other control • Curved edge design of controls follows the shape of users’ hands/fingers more naturally • Friction brakes are also located on the handle for both flexion controls Notes No. 4 SIEMENS Healthineers Z6T system configuration SIEMENS . Healthineers ... 1. Rotation – rotate 360˚ or limit rotation to 180˚ 521 Lumes 2. Free Tilt – limit the tilt to perpendicular only or a Plane. Settings Assign function to controls 5 no restrictions Rotation 3. Tilt Line Display – configure to hide tilt line 1 Free Tilt 2 Rotate at 360" O Norestrictions Di-Plane Onlos after 1.5 seconds O Limit rotation to 180% O Perpendicular on tilt 4. Default Bi-Plane+ Rotation Angle – set default Tit Cursor Display Bi-Plane+ angles to 0˚ and 90˚ or 0˚ and 270˚ 3 El Auto hide after 1.5 seconds Default MiPlanes Rotation Angle Left 8 5. Assign function to controls – four controls can LeftA be configured from 13 available options O Letto, Rote so O letto, Right 270- 4 270 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes System configuration for the Z6T includes the following options: 1. Rotation – rotate 360˚ or limit rotation to 180˚ 2. Free Tilt – limit the tilt to perpendicular only or no restrictions 3. Tilt Line Display – configure to hide tilt line after 1.5 seconds 4. Default Bi-Plane+ Rotation Angle – set default Bi-Plane+ angles to 0˚ and 90˚ or 0˚ and 270˚ 5. Assign function to controls – four controls can be configured from 13 available options Notes No. 5 SIEMENS Healthineers Z6T system configuration SIEMENS . Healthineers ... • Four configurable smart buttons • Configurable in System Configuration > Transducer > Matrix > Z6T Not Assigned V Assign function to controls Increase Depth (press-and-hold function) Decrease Depth (press-and-hold function) Latt A Right A Capture Bi-Plane Onice Color On/Off Right B Net ALSIgrad CW On/Off PW On/Off Left Freeze Lelt A Rotate Forward (press-and-hold function) Rotate Backward (press-and-hold function) Increase Tilt Angle (press-and-hold function) Right A Right & Decrease Tilt Angle (press-and-hold function) 4D On/Off 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes There are four smart buttons located on the handle of the Z6T which can be configured for quick access from a choice of commonly used functions. Available options are found in the drop-down. Notes No. 6 SIEMENS Healthineers Z6T transducer connection SIEMENS . Healthineers ... • A safety message appears when the Z6T transducer is connected to the ultrasound system Safety Instructions • Select OK to continue Refer to the warnings and precautions in the user manual before each use of the transesophageal transducer. Review instructions for leakage current testing and for inspection, proper use, and disinfection of the transesophageal transducer. • As a best practice, Freeze the image when the transducer is idle, especially prior to the start of the exam OK Author | Department 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes • A safety message appears when the Z6T transducer is connected to the ultrasound system • Select OK to continue • As a best practice, Freeze the image when the transducer is idle, especially prior to the start of the exam Notes No. 7 SIEMENS Healthineers Z6T thermal design SIEMENS . Healthineers ... Thermal design • Designed to transport heat away from the electronic components and array • Acoustic window provides thermal insulation between the acoustic array and esophagus to prevent hot spots Acoustic Window ---- .............. Front Back 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes The Z6T has unique thermal design components which prevent excessive over heating that can be common in matrix array transducers. It is designed to transport heat away from the electronic components and the array. The acoustic window provides thermal insulation between the acoustic array and the esophagus to prevent hot spots. Notes No. 8 SIEMENS Healthineers Z6T thermal management SIEMENS . Healthineers ... • Near Thermal Limit – when the transducer reaches 42˚C the A Near Thermal Limit system will display a warning message and suspend imaging Transducer temperature is 42ºC. The system has stopped imaging. Wait for the transducer to cool. Or, click Override to continue imaging. • If user selects Override, the system unfreezes and continues Override live imaging • Cool Down State – when the temperature reaches 42.5˚C, the system automatically lowers consumption by ~50% in B- mode and color flow Doppler for uninterrupted imaging (frame rates will be reduced) • Located on the second page of the touch screen Cool Down 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes The following events occur when the Z6T reaches certain thermal limits. This is to prevent damage to the patient’s esophagus. • Near Thermal Limit – when the transducer reaches 42˚C the system will display a warning message and suspend imaging • If user selects Override, the system unfreezes and continues live imaging • Cool Down State – when the temperature reaches 42.5˚C, the system automatically lowers consumption by ~50% in B-mode and color flow Doppler for uninterrupted imaging (frame rates will be reduced) • The Cool Down option is located on the second page of the touch screen when the Z6T is connected Notes No. 9 SIEMENS Healthineers Z6T Clinical Images SIEMENS . Healthineers' ... Imaging performance: Z8T:90.7"C Cardiac T15:0.68 MIO.37 56tps 95% Crisp valve appearance, without extraneous thickening 20 • • Clean chambers with minimal blood pool visualization • Adequate color Doppler sensitivity without bleeding of color into cardiac tissue • Some legacy imaging and cropping tools are integrated with workflow enhancements • Additional imaging workflow tools available 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes The top image is a 2D four chamber image demonstrating the mitral and tricuspid valves. The valves appear crisp with normal function and the chambers are crisp with minimal blood pool visualization. The bottom image is of a prolapse mitral valve with significant mitral regurgitation. The PISA flow convergence is well visualized and there is no bleeding of the color flow into the cardiac tissue. Imaging performance of the Z6T on the ACUSON Origin system includes: • Crisp valve appearance, without extraneous thickening • Clean chambers with minimal blood pool visualization • Adequate color Doppler sensitivity without bleeding of color into cardiac tissue Some of the legacy imaging and cropping tools have been integrated with workflow enhancements. In addition, some new imaging workflow tools are available. Please refer to the 4D Imaging Fundamentals presentation for more on 4D imaging workflow. Notes No. 10 SIEMENS Healthineers Bi-plane+ imaging SIEMENS. Healthineers ... Z6T : 39.0ºC ZGT : 39.0ºC Cardiac Cardiac 151 241º TIS:0.68 MI:0.56 120º TIS:0.68 MI:0.47 55fps 30fps 95% 95% 2D Mid 2dB/3dB -2dB DR60 DR60 LD 3 LD 3 UA 2 UA 2 MapD/T5 MapD/T5 9.5cm HD Z 12cm 75bpm 68bpm Lead 11 Aortic Valve Long Axis and Left Atrial Appendage 30˚ Short Axis and 120 ˚ 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes Bi-plane+ imaging offers the ability to display two different imaging planes of the same structure of interest. The benefit of Bi-plane+ is that it provides more information to the imager for diagnosis and / or intervention. The image on the left is a Bi-plane+ image of the aortic valve which displays a long axis and short axis orientation of the valve. The image on the right is a Bi-plane+ image of the left atrial appendage – one image at a 30 degree angle and the other at a 120 degree angle. This allows adequate interrogation of the appendage for thrombus or for intervention. Notes No. 11 SIEMENS Healthineers Z6T clinical images SIEMENS. Healthineers' ... Z8T: 30.7ºC Caldao TIS.0.49 MI.0.79 18.7vps 95% 4D Md SdB.DR80 MPR TB natal 4D Aortic Valve Long Axis Mitral Paravalvular Leak 4D Tricuspid Valve 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes 4D imaging with the Z6T provides the clinician with excellent real-time spatial resolution of cardiac structures. Adequate color Doppler sensitivity with clinically relevant volume rates (VPS) provides physiologically accurate detail. The image on the left is a long axis image of the aortic valve with all three MPRs display. The leaflets are well visualized with normal mobility. The middle image is a 4D color Doppler image of a prosthetic mitral valve with a paravalvular leak. Real-time full volume color Doppler with a superior volume rate provides the clinician with valuable information about the leak for diagnosis and / or intervention. The image on the right is a 4D image of a tricuspid valve in which all three leaflets are visualized. The aorta is also visualized, enabling the imager to identify anterior, posterior, and septal leaflets. Notes No. 12 SIEMENS Healthineers Z6T clinical images SIEMENS. Healthineers' ... ZGT: 40.3ºC ZGT:38.8ºC Cardiac Cardiac TIS:0.49 TIS:0.43 MI:0.74 MI:0.91 17.1vps 21.3vps 95% 95% 4D 4D Mid Mid GdB/DR60 -1dB/DR60 S3 Bro Bro Con50 Con50 MPR MPR MapD/T5 MapD/T5 Vol: MapD/T8 MapA/T8 Lead 11 216pm Lead 11 Single V – Mitral Valve Prolapse Dual V – Mitral Stenosis 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes Single V and Dual V are two commonly used quick cropping tools. The image on the left is a Single V image of a mitral valve with prolapse of the anterior leaflet. Single V enables the user to place a point of interest and draw an arrow through the anatomy of interest, in the direction they want to visualize a structure – in this case, the mitral valve from the left atrium (surgeon’s view). The image on the right is a Dual V image of mitral valve that is stenosed. Dual V allows visualization of a structure from two opposing directions – in this case, the Single V line was drawn from the left atrium and the opposite viewpoint from the left ventricle is also displayed. Notes No. 13 SIEMENS Healthineers Z6T frequencies SIEMENS . Healthineers ... 2D Fundamental 2D Harmonics 4D Display Setting PEN MID RES HMID MID TX Frequency 5.0 5.5 5.8 2.6 5.0 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes The following frequencies are available on the Z6T transducer. A higher frequency should be used for resolution or more shallow structures. A lower frequency should be used for penetration to image deeper structures. Notes No. 14 SIEMENS Healthineers UltraArt universal image processing SIEMENS .. : Healthineers ... 2D imaging Speckle Optimization Edge and Ridge Enhancement Contrast Enhancement Gain and Dynamic Range 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes A unique capability available on the system is UltraArt universal image processing. Image post-processing parameters can be selected with a single touch to instantly optimize images for different patient types. This allows quick and easy matching of the systems acoustic DNA parameters to individual patients in the specific scanning window. The effect of numerous parameter changes before they are applied can be seen on the Touch Screen display. By unifying multiple parameters into optimal settings for each individual patient, the effect of UltraArt patient specific image processing improves contrast resolution. In the end, UltraArt improves exam quality and consistency across different users by avoiding combinations of individual post processing parameters that do not provide the result the user needs. Reading physicians can look forward to better exam quality standardization. Some of the settings that are optimized include Speckle, Edge, Contrast, Gain and Dynamic Range. This is acquired during real-time, so the changes can also be applied on a frozen image. Note: The images displayed on the Touch Screen do not represent the actual image quality but are representative images to select from. The Touch Screen is designed for graphics and text display. The image screen is a high-resolution monitor designed for viewing images. The image shown above was a screen capture that shows the actual imaging. The image should be viewed and selected based on the image displayed on the image screen. Notes No. 15 SIEMENS Healthineers Notes No. 15 SIEMENS Healthineers UltraArt universal image processing SIEMENS. Healthineers ... 4D imaging • Adjust smoothing settings in 4D B- mode from the UltraArt option on the touch screen • A higher value applies an increased amount of smoothing 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes Smoothing settings in 4D B-mode can be selected from the UltraArt option on the touch screen. A higher value applies an increased amount of smoothing the 4D image. Notes No. 16 SIEMENS Healthineers Objectives SIEMENS. Healthineers .. • Discuss Z6T design and imaging features • Review care and cleaning 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes We will now review care and cleaning of the Z6T transducer. Notes No. 17 SIEMENS Healthineers Z6T leakage testing • Adapter is required to connect Z6T to leakage tester • Included in the sale of a Z6T • There are two options for leakage testers available for purchase: 1. BC Biomedical ULT-2020 2. Acertara AmpSafe Note: Existing BC Biomedical or Acertara testers can be used on the Z6T with the adaptor. Ensure it is one of these two supported models and is updated to current firmware. 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes An adapter is required to connect Z6T to a leakage tester and is included in the sale of a Z6T transducer. • There are two options for leakage testers available for the customer to purchase: 1. BC Biomedical ULT-2020 2. Acertara AmpSafe Note: Existing BC Biomedical or Acertara testers can be used on the Z6T with the adaptor. Ensure it is one of these two supported models and is updated to current firmware. Notes No. 18 SIEMENS Healthineers BC Biomedical ULT-2020 • Most common leakage tester • Tub and conductivity probe included in Dar1 5120 ULT-2020 09:55 PM kit Ready for Teatro Press Bath Test or • Will contain Siemens Z6T Pass / Fail Full Test lo bes data which is selectable in the user interface • Results logging feature is included • Conductivity probe is more convenient for customers that use automated reprocessing machines ULT-2029 VITRASOUND TRANSDUCER LEAKAGE TESTES 19 Unrestricted © Siemens Healthineers 2023 Speaker Notes The BC Biomedical ULT-2020 is the most common leakage tester on the market. • Tub and conductivity probe included in kit, or the customer may have an automated probe cleaner system • Will contain Siemens Z6T Pass / Fail data which is selectable in the user interface • Results logging feature is included • Conductivity probe is more convenient for customers that use automated reprocessing machines Notes No. 19 SIEMENS Healthineers ACERTARA AmpSafe • BATH PROBE Must connect to a phone / tablet / computer • Tablet purchasable though Siemens Healthineers • Advanced data logging with cloud AmpSafe support through Acertera • Tub and conductivity probe included in kit • Will contain Siemens Z6T Pass / Fail data which is selectable in the user interface ACERTARA coustic laboratories 20 Unrestricted © Siemens Healthineers 2023 Speaker Notes The ACERTARA AmpSafe must be connected to a phone / tablet / computer. • Tablet is purchasable though Siemens Healthineers • Advanced data logging with cloud support through Acertera • Tub and conductivity probe are included in kit, or the customer may have an automated probe cleaner system • Will contain Siemens Z6T Pass / Fail data which is selectable in the user interface Notes No. 20 SIEMENS Healthineers Approved cleaners and disinfectants Approved Cleaners Approved Disinfectants ANIOSYME DD1 CIDEX OPA ENZOL gigasept FF (new) Protex ULTRA Disinfectant Wipes Clinell Universal Wipes & Spray Virex II 256 Sani-Cloth AF3 Germicidal Disposable Wipe Sani-Cloth HB Germicidal Disposable Wipe Super Sani-Cloth Germicidal Disposable Wipe TD-5 1 TD-8 1 1For use only with the TD-100 Automated TEE Probe Disinfector according 21 to the device manufacturer’s instructions for use. Unrestricted © Siemens Healthineers 2023 Speaker Notes The following cleaners and disinfectants are approved for use with the Z6T transducer. Notes No. 21 SIEMENS Healthineers Z6T care and cleaning – initial cleaning Initial cleaning of the Z6T transducer should include the following steps: 1. Disconnect and remove the transducer from the ultrasound system. 2. Remove the transducer sheath. 3. Immediately clean the transducer in close proximity to the point of use. a. Moisten a clean gauze pad or lint-free cloth with water or an approved cleaner, or use an approved cleaning wipe or sponge. b. Carefully wipe the transducer surface intended for contact with the patient. Avoid touching the electrical components on the connector. 4. Perform subsequent cleaning of the transducer according to the next procedure. Note: It is important to clean the transducer immediately after each use to prevent soil and contaminants from drying on the surface of the transducer and facilitates subsequent cleaning. 22 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 22 SIEMENS Healthineers Z6T care and cleaning – initial cleaning 5. Select an approved cleaner. Follow the manufacturer's instructions for concentration and temperature of the solution and contact time when cleaning the surface of the transducer. 6. Clean the distal tip and flexible shaft of the transducer using one of the following cleaning methods. Avoid touching the electrical components on the connector. a. If immersion is required, submerge the distal tip and flexible shaft up to the 100 cm mark. Do not allow the handle, controls, cable, or connector to become wet. b. If wiping is required, carefully wipe the distal tip and flexible shaft. c. If spraying is required, do not spray the distal tip and flexible shaft near the ultrasound system. Never spray the transducer connector. 7. Clean the handle, controls, cable, and connector of the transducer. Keep the electrical components on the connector dry. a. Moisten a clean gauze pad or lint-free cloth with an approved cleaner. Or, use an approved cleaning wipe. b. Carefully wipe the handle, controls, cable, and connector. 23 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 23 SIEMENS Healthineers Z6T care and cleaning – initial cleaning 8. Rinse the distal tip and flexible shaft up to the 100-cm mark according to the cleaner manufacturer's instructions. Do not rinse the handle, controls, cable, and connector. Keep the electrical components on the connector dry. Note: If the cleaner manufacturer does not provide rinsing instructions, thoroughly rinse the distal tip and flexible shaft up to the 100-cm mark with deionized water at room temperature. 9. Disinfect the transducer. 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 24 SIEMENS Healthineers Z6T care and cleaning – disinfecting Immediately after cleaning, disinfect the transducer to destroy pathogens and other microorganisms and to prepare the transducer for storage or the next exam. 1. Select an approved disinfectant for high-level disinfection. Follow the disinfectant manufacturer's instructions for concentration and temperature of the solution and contact time when high-level disinfecting the surface of the transducer. 2. Disinfect the distal tip and flexible shaft of the transducer using one of the following disinfection methods. Avoid touching the electrical components on the connector. a. If immersion is required, submerge the distal tip and flexible shaft up to the 100-cm mark. Do not allow the handle, controls, cable, or connector to become wet. b. If wiping is required, carefully wipe the distal tip and flexible shaft. c. If spraying is required, do not spray the distal tip and flexible shaft near the ultrasound system. Never spray the transducer connector. d. If a reprocessing device is required, use a device compliant with ISO 15883 and follow the reprocessing device manufacturer's instructions 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 25 SIEMENS Healthineers Z6T care and cleaning – disinfecting 3. Disinfect the handle, controls, cable, and connector of the transducer. Keep the electrical components on the connector dry. a. Moisten a clean gauze pad or lint-free cloth with an approved high-level disinfectant. Or use an approved disinfectant wipe. b. Carefully wipe the handle, controls, cable, and connector. 4. Rinse the distal tip and flexible shaft of the transducer up to the 100-cm mark according to the disinfectant manufacturer's instructions. Do not rinse the handle, controls, cable, and connector. Keep the electrical components on the connector dry. Note: If the disinfectant manufacturer does not provide rinsing instructions, thoroughly rinse the distal tip and flexible shaft up to the 100-cm mark with deionized water at room temperature. 26 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 26 SIEMENS Healthineers Z6T care and cleaning – disinfecting 5. Follow the disinfectant manufacturer's instructions for drying the transducer. Do not use heated air. Note: If the disinfectant manufacturer does not provide drying instructions, dry the transducer with a clean, lint-free, soft cloth. 6. Apply an approved disposable tip protector to the distal tip before storage. 27 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the care and cleaning instructions listed. Refer to the user manual for additional information. Notes No. 27 SIEMENS Healthineers Z6T storage and handling • The transesophageal transducer is a mechanically sensitive device. The distal tip is especially sensitive to bumps, scrapes, and jarring. Take extreme care when handling and storing the transducer. Never move the distal tip by hand. Always use the flex controls. • When you store the transducer, ensure that the friction brakes are off, the distal tip is straight, and the cables and flexible shaft are free of kinks. • Use an approved disposable tip protector on the distal tip during storage. • Store the transducer in a clean, dry, protected environment. The transesophageal transducer is fragile and should not be stored in the transducer holders on the system. 28 Unrestricted © Siemens Healthineers 2023 Speaker Notes Follow the storage and handling instructions listed. Refer to the user manual for additional information. Notes No. 28 SIEMENS Healthineers Trademarks and disclaimers The products/features mentioned in this document 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. ACUSON O r i g in, T E Q , a nd U l t r aArt a r e trademarks of Siemens Medical Solutions USA, Inc. At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We’re a leading medical technology company with over 120 years of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Phone: +49 9131 84-0 Issaquah, WA 98029, USA siemens-healthineers.com Phone: 1-888-826-9702 siemens-heathineers.com/ultrasound 29 Unrestricted © Siemens Healthineers 2023 Notes No. 29 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? 30 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Questions? Notes No. 30