Towards navigation on the heart surface during coronary arterty bypass grafting

Gnahm, Claudia; Hartung, Christine; Friedl, Reinhard; Hoffmann, Martin; Dietmayer, Klaus

doi:10.1007/s11548-008-0273-y

Cited by 3 publications

(5 citation statements)

References 14 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Clinical Summarymentioning

confidence: 99%

“…In a hybrid operating theater, the surface mesh, including the three eyelets and the two added planes was registered onto the fluoroscopic image (Figure 2b) and dynamic tracking was implemented 2 to maintain the superimposition on the moving fluoroscopic image (Video S1). This was performed through a stand‐alone, homemade software, with continuous access to the real‐time native imaging data.…”

Section: Clinical Summarymentioning

confidence: 99%

“…The place of computer assistance in cardiac procedures has been suggested over 20 years ago. 1,2 Recent applications offer solutions from case planning in transcatheter aortic valve implantation (TAVI), 3 to procedural assistance in ViV procedures. 4 We therefore sought to evaluate the clinical use of computer-based assistance to perform a ViV procedure in a degenerated Mosaic valve under augmented fluoroscopy.…”

Section: Introductionmentioning

confidence: 99%

“…The place of computer assistance in cardiac procedures has been suggested over 20 years ago 1,2 . Recent applications offer solutions from case planning in transcatheter aortic valve implantation (TAVI), 3 to procedural assistance in ViV procedures 4 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Computer‐assisted valve in valve in a deteriorated Mosaic valve using a library of bioprostheses

Soulami

Castro²,

Haigron³

et al. 2020

Cathet Cardio Intervent

View full text Add to dashboard Cite

Valve‐in‐valve (ViV) procedures have emerged from an off‐label procedure to a safe and efficient alternative to redo aortic valve replacement in the treatment of symptomatic structural valve deterioration (SVD). During ViV procedures, optimal placement of the transcatheter heart valve (THV) inside the degenerated bioprosthesis is of paramount importance regarding complications such as device embolization, coronary obstruction, periprosthetic regurgitation, residual gradients, and mitral valve injury, but also for the attainment of optimal hemodynamics. In the case of the Mosaic (Medtronic, Minneapolis, MN) valve, the limited radiopaque landmarks represent a challenge to a reproducible, optimal implantation. Such implantation may require multiple contrast injections and transesophageal echocardiogram (TEE) guidance. We herein describe a computer‐assisted ViV procedure inside a deteriorated Mosaic valve, achieving reproducible optimal placement using a preacquired library of bioprostheses 3D models. Our approach suggests an evolving paradigm in ViV procedures, from safe and efficient toward optimal therapy for symptomatic SVD.

show abstract

Section: Clinical Summarymentioning

confidence: 99%

Section: Clinical Summarymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Computer‐assisted valve in valve in a deteriorated Mosaic valve using a library of bioprostheses

Soulami

Castro²,

Haigron³

et al. 2020

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…While the conventional CABG procedure involves median sternotomy to expose the heart and gain access to the coronary vessels, scientists have been investigating alternative ways to minimize the invasiveness of open-chest CABG and reduce patient morbidity. As an example, Gnahm et al 1 proposed the integration of preoperative computed tomography (CT) with intra-operative stereoscopic endoscopy to improve the localization of the vessel to be grafted and enhance visualization during guidance. Over the past decade, the use of robotic assistance as a means of reducing the invasiveness of the procedure has experienced increased popularity for CABG interventions.…”

Section: Introductionmentioning

confidence: 99%

Predicting target vessel location on robot-assisted coronary artery bypass graft using CT to ultrasound registration

et al. 2012

View full text Add to dashboard Cite

Although robot-assisted coronary artery bypass grafting (RA-CABG) has gained more acceptance worldwide, its success still depends on the surgeon's experience and expertise, and the conversion rate to full sternotomy is in the order of 15%-25%. One of the reasons for conversion is poor preoperative planning, which is based solely on pre-operative computed tomography (CT) images. In this paper, the authors propose a technique to estimate the global peri-operative displacement of the heart and to predict the intra-operative target vessel location, validated via both an in vitro and a clinical study. Methods: As the peri-operative heart migration during RA-CABG has never been reported in the literatures, a simple in vitro validation study was conducted using a heart phantom. To mimic the clinical workflow, a pre-operative CT as well as peri-operative ultrasound images at three different stages in the procedure (Stage 0-following intubation; Stage 1-following lung deflation; and Stage 2-following thoracic insufflation) were acquired during the experiment. Following image acquisition, a rigid-body registration using iterative closest point algorithm with the robust estimator was employed to map the pre-operative stage to each of the peri-operative ones, to estimate the heart migration and predict the peri-operative target vessel location. Moreover, a clinical validation of this technique was conducted using offline patient data, where a Monte Carlo simulation was used to overcome the limitations arising due to the invisibility of the target vessel in the peri-operative ultrasound images. Results: For the in vitro study, the computed target registration error (TRE) at Stage 0 , Stage 1 , and Stage 2 was 2.1, 3.3, and 2.6 mm, respectively. According to the offline clinical validation study, the maximum TRE at the left anterior descending (LAD) coronary artery was 4.1 mm at Stage 0 , 5.1 mm at Stage 1 , and 3.4 mm at Stage 2. Conclusions: The authors proposed a method to measure and validate peri-operative shifts of the heart during RA-CABG. In vitro and clinical validation studies were conducted and yielded a TRE in the order of 5 mm for all cases. As the desired clinical accuracy imposed by this procedure is on the order of one intercostal space (10-15 mm), our technique suits the clinical requirements. The authors therefore believe this technique has the potential to improve the pre-operative planning by updating peri-operative migration patterns of the heart and, consequently, will lead to reduced conversion to conventional open thoracic procedures. V

show abstract

Der Hybridoperationssaal

et al. 2012

View full text Add to dashboard Cite

A hybrid operating room must serve the medical needs of different highly specialized disciplines. It integrates interventional techniques for cardiovascular procedures and allows operations in the field of orthopaedic surgery, neurosurgery and maxillofacial surgery. The integration of all steps such as planning, documentation and the procedure itself saves time and precious resources. The best available imaging devices and user interfaces reduce the need for extensive personnel in the OR and facilitate new minimally invasive procedures. The immediate possibility of postoperative control images in CT-like quality enables the surgeon to react to problems during the same procedure without the need for later revision.

show abstract

Towards navigation on the heart surface during coronary arterty bypass grafting

Cited by 3 publications

References 14 publications

Computer‐assisted valve in valve in a deteriorated Mosaic valve using a library of bioprostheses

Computer‐assisted valve in valve in a deteriorated Mosaic valve using a library of bioprostheses

Predicting target vessel location on robot-assisted coronary artery bypass graft using CT to ultrasound registration

Der Hybridoperationssaal

Contact Info

Product

Resources

About