Robotics in valvular surgery: 2003 and beyond

Ap, Kypson; Je, Felger; Lw, Nifong; Wr, Chitwood

doi:10.1097/00001573-200403000-00011

Cited by 16 publications

(9 citation statements)

References 13 publications

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“…Telemanipulator-supported operations, which involve femoral cannulation and direct or endoluminal aortic clamping, have been used and propagated by Chitwood et al (17,23) and others (36,37), who claim that this technique could be safely and effectively used (28). Recently, another group reported the results of 25 patients receiving successful telemanipulator-supported mini-MVS (38); however, long-term results are not available.…”

Section: Techniques Of Mini-vsmentioning

confidence: 99%

Minimally-Invasive Valve Surgery

Schmitto

Mokashi

Cohn

2010

Journal of the American College of Cardiology

260

170

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Section: Techniques Of Mini-vsmentioning

confidence: 99%

Minimally-Invasive Valve Surgery

Schmitto

Mokashi

Cohn

2010

Journal of the American College of Cardiology

260

170

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“…Advances in closed-chest cardiopulmonary bypass (CPB) and myocardial preservation, as well as improved intracardiac visualization have stimulated the shift towards efficient and safe minimally-invasive cardiac procedures, which include percutaneous and robotically-assisted interventions. 5 Percutaneous mitral commissurotomy and valvuloplasty have been performed since the mid 1980s and have proved feasible for these applications. Balloon commissurotomy has been used extensively and provides good long-and short-term results in a wide range of patients.…”

Section: Introductionmentioning

confidence: 99%

An augmented reality environment for image-guidance of off-pump mitral valve implantation

Linte

Wiles

Hill

et al. 2007

Medical Imaging 2007: Visualization and Image-Guided Procedures

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Clinical research has been rapidly evolving towards the development of less invasive surgical procedures. We recently embarked on a project to improve intracardiac beating heart interventions. Our novel approach employs new surgical technologies and support from image-guidance via pre-operative and intra-operative imaging (i.e. two-dimensional echocardiography) to substitute for direct vision. Our goal was to develop a versatile system that allowed for safe cardiac port access, and provide sufficient image-guidance with the aid of a virtual reality environment to substitute for the absence of direct vision, while delivering quality therapy to the target. Specific targets included the repair and replacement of heart valves and the repair of septal defects. The ultimate objective was to duplicate the success rate of conventional open-heart surgery, but to do so via a small incision, and to evaluate the efficacy of the procedure as it is performed. This paper describes the software and hardware components, along with the methodology for performing mitral valve replacement as one example of this approach, using ultrasound and virtual tool models to position and fasten the valve in place.

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“…1 Furthermore, cardiac valve repair and replacement have been demonstrated using both robotic and percutaneous approaches with cardiopulmonary bypass. [2][3][4][5][6] In the cases presented, the invasiveness of the procedures has been reduced significantly by the elimination of the sternotomy but a cardiopulmonary bypass is still typically required in order to operate on the heart. It is anticipated that a closed chest, beating heart procedure for valve replacement and septal defect repair can further reduce the invasiveness of cardiac procedures.…”

Section: Introductionmentioning

confidence: 99%

Navigation accuracy for an intracardiac procedure using ultrasound enhanced virtual reality

Wiles

Guiraudon

Moore

et al. 2007

Medical Imaging 2007: Visualization and Image-Guided Procedures

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Minimally invasive techniques for use inside the beating heart, such as mitral valve replacement and septal defect repair, are the focus of this work. Traditional techniques for these procedures require an open chest approach and a cardiopulmonary bypass machine. New techniques using port access and a combined surgical guidance tool that includes an overlaid two-dimensional ultrasound image in a virtual reality environment are being developed. To test this technique, a cardiac phantom was developed to simulate the anatomy. The phantom consists of an acrylic box filled with a 7% glycerol solution with ultrasound properties similar to human tissue. Plate inserts mounted in the box simulate the physical anatomy. An accuracy assessment was completed to evaluate the performance of the system.Using the cardiac phantom, a 2mm diameter glass toroid was attached to a vertical plate as the target location. An elastic material was placed between the target and plate to simulate the target lying on a soft tissue structure. The target was measured using an independent measurement system and was represented as a sphere in the virtual reality system. The goal was to test the ability of a user to probe the target using three guidance methods: (i) 2D ultrasound only, (ii) virtual reality only and (iii) ultrasound enhanced virtual reality. Three users attempted the task three times each for each method. An independent measurement system was used to validate the measurement. The ultrasound imaging alone was poor in locating the target (5.42 mm RMS) while the other methods proved to be significantly better (1.02 mm RMS and 1.47 mm RMS respectively). The ultrasound enhancement is expected to be more useful in a dynamic environment where the system registration may be disturbed.

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Robotics in valvular surgery: 2003 and beyond

Cited by 16 publications

References 13 publications

Minimally-Invasive Valve Surgery

Minimally-Invasive Valve Surgery

An augmented reality environment for image-guidance of off-pump mitral valve implantation

Navigation accuracy for an intracardiac procedure using ultrasound enhanced virtual reality

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