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The registration method presented here is capable of matching the relevant parts of a preoperatively extracted map of the coronaries with intraoperatively recorded optical tracking data. Thus, it can be used as a basis for a surgical navigation system intended to assist the surgeon in the localisation of the optimal anastomotic site during CABG.

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Objective Open heart bypass graft surgery is the standard treatment for advanced cases of coronary heart disease. Optimal placement of the bypass graft anastomosis is very important for the success of the procedure. Therefore, detailed and precise knowledge about the path and morphology of the target vessel is crucial for the operating surgeon. Materials and methods To provide such information during the procedure, a novel surgical assistance system for open heart bypass graft surgery was designed which merges preoperative maps of the coronary arteries with intraoperative data. The patient-specific vessel map was generated from multi-slice computed tomography (MSCT), while the intraoperative data were obtained using a stereo camera system. A registration approach based on mutually shared anatomical landmarks on the heart surface was employed. Results Successful registration of MSCT and stereo video data was performed for five patients, demonstrating that 2D-2D and 3D-3D Procrustes registration could produce mean accuracies between 2 and 5 mm. Conclusion The target vessel visualization and registration approach presented in this work is feasible and can produce accuracies sufficient to justify future in vivo intraoperative testing.

Abstract. Coronary artery bypass grafting (CABG) is the standard treatment for advanced coronary artery diseases (CAD). Optimal placement of the bypass graft on the diseased vessel is very important. To assist the surgeon in this matter, a computer assistance system has been developed facilitating navigation on the heart surface. After retrospective validation on patient data sets yielded good results, the system was successfully applied for in-vivo navigation on the front side of the heart during several CABG procedures. Postoperative evaluation confirmed that intraoperative navigation has been performed with adequate accuracy.