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This paper presents a concurrency control mechanism that does not follow a "one concurrency control mechanism fits all needs" strategy. With the presented mechanism a transaction runs under several concurrency control mechanisms and the appropriate one is chosen based on the accessed data. For this purpose, the data is divided into four classes based on its access type and usage (semantics). Class O (the optimistic class) implements a first-committer-wins strategy, class R (the reconciliation class) implements a first-n-committers-win strategy, class P (the pessimistic class) implements a first-reader-wins strategy, and class E (the escrow class) implements a first-n-readers-win strategy. Accordingly, the model is called OjRjPjE. The selected concurrency control mechanism may be automatically adapted at run-time according to the current load or a known usage profile. This run-time adaptation allows OjRjPjE to balance the commit rate and the response time even under changing conditions. OjRjPjE outperforms the Snapshot Isolation concurrency control in terms of response time by a factor of approximately 4.5 under heavy transactional load (4000 concurrent transactions). As consequence, the degree of concurrency is 3.2 times higher.
Background and purpose: Transapical aortic valve replacement (TAVR) is a recent minimally invasive surgical treatment technique for elderly and high-risk patients with severe aortic stenosis. In this paper,a simple and accurate image-based method is introduced to aid the intra-operative guidance of TAVR procedure under 2-D X-ray fluoroscopy.
Methods: The proposed method fuses a 3-D aortic mesh model and anatomical valve landmarks with live 2-D fluoroscopic images. The 3-D aortic mesh model and landmarks are reconstructed from interventional X-ray C-arm CT system, and a target area for valve implantation is automatically estimated using these aortic mesh models.Based on template-based tracking approach, the overlay of visualized 3-D aortic mesh model, land-marks and target area of implantation is updated onto fluoroscopic images by approximating the aortic root motion from a pigtail catheter motion without contrast agent. Also, a rigid intensity-based registration algorithm is used to track continuously the aortic root motion in the presence of contrast agent.Furthermore, a sensorless tracking of the aortic valve prosthesis is provided to guide the physician to perform the appropriate placement of prosthesis into the estimated target area of implantation.
Results: Retrospective experiments were carried out on fifteen patient datasets from the clinical routine of the TAVR. The maximum displacement errors were less than 2.0 mm for both the dynamic overlay of aortic mesh models and image-based tracking of the prosthesis, and within the clinically accepted ranges. Moreover, high success rates of the proposed method were obtained above 91.0% for all tested patient datasets.
Conclusion: The results showed that the proposed method for computer-aided TAVR is potentially a helpful tool for physicians by automatically defining the accurate placement position of the prosthesis during the surgical procedure.