Open-Source Tool Kit for Interactive Planning of Transcatheter Mitral Valve Replacement Using Multimodality Imaging

Herz, Christian; Cianciulli, Alana; Ching, Stephen; Vigil, Chad; Lassó, András; Nam, Hannah H.; Drouin, Simon; Biko, David M.; Gillespie, Matthew J.; Fichtinger, Gabor; Jolley, Matthew A.

doi:10.1016/j.echo.2021.03.014

Cited by 2 publications

(4 citation statements)

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“…Some of these tools are now used clinically at our institution, such as the baffle planner, demonstrating clinical translation ( 29 ). While our efforts have focused on application to pediatric populations, there is clear relevance of other SlicerHeart modules to larger adult populations such as those focused on planning interventions for transcatheter edge-to-edge repair, and transcatheter mitral valves ( 7 , 23 ). Further, allied toolkits like the PLUS toolkit and SlicerIGT ( 15 , 20 ) allow the integration of images for the active guidance of procedures themselves, as has been demonstrated in neurosurgical and abdominal procedures.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously demonstrated application of the Annular Modeling module for a mitral valve using 3DE and cardiac CT ( 23 ). Modeling begins by choosing the probe orientation to register the image, then refining the views to align one plane through the plane of the annulus and the other two views orthogonal to the annulus ( Figure 3 and Supplementary Video 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…The new Valve Quantification module within SlicerHeart allows semi-automatic quantification of important annular and leaflet metrics ( Figures 4 , 5 and Supplementary Video 4 ). A preliminary version of this workflow has been used to generate mitral annular quantification for assessment of suitability for transcatheter mitral valve as we have recently described ( 23 ). Custom adaptations of this workflow have been applied to investigations of the tricuspid annulus in hypoplastic left heart syndrome and of the annulus of the native, unrepaired valve in complete atrioventricular canal ( 26 , 49 ).…”

Section: Introductionmentioning

confidence: 99%

“…We have customized workflows for a diverse group of transcatheter procedures including self-expanding transcatheter pulmonary valves in CT datasets and transcatheter atrial and ventricular septal occlusion devices within 3DE datasets ( Figure 8 ) ( 22 , 32 , 40 ). Further specialization of this general toolkit has now been implemented to support the modeling of transcatheter mitral valves and transcatheter edge-to-edge therapies which we have recently demonstrated ( Figure 9 ) ( 7 , 23 ). All simulated devices available in the Cardiac Device Simulator Module can be inserted into segmented or volume rendered images (3DE, CT, CMR) and visualized on screen or in virtual reality.…”

Section: Introductionmentioning

confidence: 99%

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SlicerHeart: An open-source computing platform for cardiac image analysis and modeling

Lassó

Herz

Nam

et al. 2022

Front. Cardiovasc. Med.

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Cardiovascular disease is a significant cause of morbidity and mortality in the developed world. 3D imaging of the heart's structure is critical to the understanding and treatment of cardiovascular disease. However, open-source tools for image analysis of cardiac images, particularly 3D echocardiographic (3DE) data, are limited. We describe the rationale, development, implementation, and application of SlicerHeart, a cardiac-focused toolkit for image analysis built upon 3D Slicer, an open-source image computing platform. We designed and implemented multiple Python scripted modules within 3D Slicer to import, register, and view 3DE data, including new code to volume render and crop 3DE. In addition, we developed dedicated workflows for the modeling and quantitative analysis of multi-modality image-derived heart models, including heart valves. Finally, we created and integrated new functionality to facilitate the planning of cardiac interventions and surgery. We demonstrate application of SlicerHeart to a diverse range of cardiovascular modeling and simulation including volume rendering of 3DE images, mitral valve modeling, transcatheter device modeling, and planning of complex surgical intervention such as cardiac baffle creation. SlicerHeart is an evolving open-source image processing platform based on 3D Slicer initiated to support the investigation and treatment of congenital heart disease. The technology in SlicerHeart provides a robust foundation for 3D image-based investigation in cardiovascular medicine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

SlicerHeart: An open-source computing platform for cardiac image analysis and modeling

Lassó

Herz

Nam

et al. 2022

Front. Cardiovasc. Med.

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A Computational Framework for Atrioventricular Valve Modeling Using Open-Source Software

Ching

Maas

et al. 2022

Journal of Biomechanical Engineering

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Atrioventricular valve regurgitation is a significant cause of morbidity and mortality in patients with acquired and congenital cardiac valve disease. Image-derived computational modeling of atrioventricular valves has advanced substantially over the last decade and holds particular promise to inform valve repair in small and heterogeneous populations, which are less likely to be optimized through empiric clinical application. While an abundance of computational biomechanics studies have investigated mitral and tricuspid valve disease in adults, few studies have investigated application to vulnerable pediatric and congenital heart populations. Further, to date, investigators have primarily relied upon a series of commercial applications that are neither designed for image-derived modeling of cardiac valves, nor freely available to facilitate transparent and reproducible valve science. To address this deficiency, we aimed to build an open-source computational framework for the image-derived biomechanical analysis of atrioventricular valves. In the present work, we integrated an open-source valve modeling platform, SlicerHeart, and an open-source biomechanics finite element modeling software, FEBio, to facilitate image-derived atrioventricular valve model creation and finite element analysis. We present a detailed verification and sensitivity analysis to demonstrate the fidelity of this modeling in application to 3D echocardiography-derived pediatric mitral and tricuspid valve models. Our analyses achieved excellent agreement with those reported in the literature. As such, this evolving computational framework offers a promising initial foundation for future development and investigation of valve mechanics, in particular collaborative efforts targeting the development of improved repairs for children with congenital heart disease.

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Open-Source Tool Kit for Interactive Planning of Transcatheter Mitral Valve Replacement Using Multimodality Imaging

Cited by 2 publications

References 7 publications

SlicerHeart: An open-source computing platform for cardiac image analysis and modeling

SlicerHeart: An open-source computing platform for cardiac image analysis and modeling

A Computational Framework for Atrioventricular Valve Modeling Using Open-Source Software

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