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International Society For Minimally Invasive Cardiothoracic Surgery

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3d Hologram Virtual Reality Evaluation In Cardiovascular Surgery
Takeo Tedoriya, Tadamasa Miyauchi, Masaomi Fukuzumi, Yuji Ohtake, Yuko Gatate.
Ageo Central General Hospital, Ageo, Saitama, Japan.

BACKGROUND: Anatomical evaluation under physiologic status would be quite important to achieve various kinds of cardiac surgical procedures especially in the aortic root surgery and possibly in any structural heart diseases and aortic diseases by endovascular or catheter approach. We introduced novel workstations which create 3D Hologram Virtual Reality (3D-VR) Images in the field of cardiovascular surgery. We present 3D-VR evaluation in the aortic root surgery including valve sparing aortic root surgery (VSARS) and aortic valve leaflet reconstruction (AVLRS) as well as complicated procedures of thoracic endovascular aortic repair (TEVAR).
METHODS: Enrolled patients for the aortic root surgery 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. Patients for the aortic disease also underwent enhanced thoracic, abdominal, and pelvic CT. Axial images using a 264-row CT with slice thickness of 0.625mm were obtained early and late phase of enhanced images. Digital imaging and communications in medicine or DICOM data of these CT images were installed a novel workstation, EchoPixel Ture3D.
RESULTS: We present representative utilities of 3D-VR analysis. 1) VSARS: 3D-VR analysis could indicate important measurements like geometry height, Brussel height preoperatively, and clarify distortion of three commissures and deviation of nadirs, which were not easy to identify even intraoperative findings. 2) AVLRS: 3D-VR image analysis had notably provided valuable information for understanding of precise anatomy of the aortic root, especially the nadir of non-coronary Valsalva deviation toward the left ventricle. Also in some of bicuspid aortic valve cases, we could simulate all procedures using 3D-VR image which was quite useful as a navigation of the surgery. 3) TEVAR: We have performed complicated TEVAR technique for thoraco-abdominal aneurysm, which required various kinds of technique. 3D-VR analysis was useful to clarify the precise situation of branching pattern and each direction and of small branches
CONCLUSIONS:3D-VR image analysis had notably provided valuable information for understanding of precise anatomy under physiological condition in the field of cardiovascular surgery. Further growth would be promising


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