Simulation of Delivery of Clip-Based Therapies Within Multimodality Images to Facilitate Preprocedural Planning

Cianciulli, Alana; Lassó, András; Pintér, Csaba; Ching, Stephen; Ghosh, Reena M.; Chen, Tiffany; Herz, Christian; Vigil, Chad; Drouin, Simon; Rogers, Lindsay S.; Quartermain, Michael D.; Biko, David M.; Whitehead, Kevin K.; Fichtinger, Gabor; Gillespie, Matthew J.; Jolley, Matthew A.

doi:10.1016/j.echo.2021.07.001

Cited by 5 publications

(13 citation statements)

References 7 publications

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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%

“…Patient-specific, image-derived modeling and simulation are particularly relevant to the treatment of congenital heart disease ( 6 , 7 ). A highly customized approach to surgical repair and intervention is frequently needed due to the inherently atypical and variable anatomy ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, until SlicerHeart, 3D Slicer did not have the ability to import or visualize 3DE data, volume render 3DE data, nor have the workflows dedicated to the evaluation and modeling of cardiovascular structures such as cardiac valves. Although the initial development of these tools was focused on pediatrics and 3DE images, we have now demonstrated application to multiple cardiovascular diseases with clear relevance to all ages ( 7 , 21 – 29 ). Despite not being formally released until now, at the time of writing, SlicerHeart has been downloaded over 43,000 times since inception in 2015.…”

Section: Introductionmentioning

confidence: 99%

“…However, an infinite number of scenarios can be created using basic Euclidian metric, as we have demonstrated for the tricuspid valve and complete atrioventricular canal valve ( 26 , 40 ). Notably the module is agnostic to data type, and can be applied to 3DE, CT, rotational angiography, CMR or any other type of data which can be imported into 3D Slicer ( 7 ).…”

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%

Section: Introductionmentioning

confidence: 99%

See 3 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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Introduction of transcatheter edge‐to‐edge repair in patients with congenital heart disease at a children's hospital

Jolley,

Sulentic,

Amin

et al. 2023

Cathet Cardio Intervent

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BackgroundAtrioventricular valve regurgitation (AVVR) is a devastating complication in children and young adults with congenital heart disease (CHD), particularly in patients with single ventricle physiology. Transcatheter edge‐to‐edge repair (TEER) is a rapidly expanding, minimally invasive option for the treatment of AVVR in adults that avoids the morbidity and mortality associated with open heart surgery. However, application of TEER in in CHD and in children is quite novel. We describe the development of a peri‐procedural protocol including image‐derived pre‐intervention simulation, with successful application to four patients.AimsTo describe the initial experience using the MitraClip system for TEER of dysfunctional systemic atrioventricular valves in patients with congential heart disease within a pediatric hospital.MethodsA standardized screening and planning process was developed using cardiac magnetic resonance imaging, three dimensional echocardiography and both virtual and physical simulation. Procedures were performed using the MitraClip G4 system and patients were clinically followed post‐intervention.ResultsA series of four CHD patients with at least severe AVVR were screened for suitability for TEER with the MitraClip system: three patients had single ventricle physiology and Fontan palliation, and one had repair of a common atrioventricular canal defect. Each patient had at least severe systemic AVVR and was considered at prohibitively high risk for surgical repair. Each patient underwent a standardized preprocedural screening protocol and image‐derived modeling followed by the TEER procedure with successful clip placement at the intended location in all cases.ConclusionsThe early results of our protocolized efforts to introduce TEER repair of severe AV valve regurgitation with MitraClip into the CHD population within our institution are encouraging. Further investigations of the use of TEER in this challenging population are warranted.

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Physical Simulation of Transcatheter Edge-to-Edge Repair Using Image-Derived 3D Printed Heart Models

Ching

Cianciulli²,

Flynn³

et al. 2023

Annals of Thoracic Surgery Short Reports

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Simulation of Delivery of Clip-Based Therapies Within Multimodality Images to Facilitate Preprocedural Planning

Cited by 5 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

Introduction of transcatheter edge‐to‐edge repair in patients with congenital heart disease at a children's hospital

Physical Simulation of Transcatheter Edge-to-Edge Repair Using Image-Derived 3D Printed Heart Models

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