3d Hologram Evaluation For Cardiovascular Surgery Using A New Workstation Visalius3d
Takeo Tedoriya, Kenichi Kamiya, Tadamasa Miyauchi, Masaomi Fukuzumi, Ryoi Okano, Yuko Gatate.
Ageo Central General Hospital, Ageo, Saitama, Japan.
BACKGROUND Anatomical comprehension for surgery should be based up physiologic status. Especially the field of heart valve surgery requires physio-anatomical evaluation for physiologic repair such as aortic or mitral repair. We introduced 3D hologram with a novel workstation Visalius 3D for the aortic valve surgery. METHODS 3D Hologram; Enrolled patients underwent enhanced ECG-triggered cardiac CT. Axial images using a 264-row CT with slice thickness of 0.625mm were obtained during mid-to-end diastole. Subtracted volume rendering data of the aortic root were converted to stereolithography file in Visalius3D. Operation of 3D Hologram using Visalius3D; Operators wore 3D glasses in front of Visalius monitor to observe the image as 3D hologram, using two tracking balls. Operators rotated 3D images by 360-degree in any direction using one ball. By another ball, operators controlled the depth and/or the direction of observation objects, and zoomed the image which allow to observe any parts of the heart from inside. The images were able to be cropped depending upon targets. Of course, length of curving lines or areas could be measured three-dimentionally. Evaluation of the aortic root; The aortic root was assessed in order to decide neo-commissure and offsetting of deviated nadir in cases of unbalanced aortic root like bicuspid aortic valve for the aortic valve leaflet reconstruction (AVLR) or stentless valve SOLO SMART. RESULTS Valsalva plication and commissure adjustment navigated by 3D hologram were accomplished for AVLR. Also, SOLO valve were implanted in adequate position guided by preoperative information of 3D hologram in patients with Type 0 bicuspid aortic valve. Postoperative outcomes were optimal without any development of AR during follow-up. CONCLUSIONS Preoperative evaluation by 3D-Hologram had notably provides valuable information for adjustment of neo-commissure and nadir in the aortic valve surgery.
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