A navigation platform for guidance of beating heart transapical mitral valve repair

John T. Moore, Michael W.A. Chu, Bob Kiaii, Daniel Bainbridge, Gerard Guiraudon, Chris Wedlake, Maria Currie, Martin Rajchl, Rajni V. Patel, Terry M. Peters

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Traditional surgical approaches for repairing diseased mitral valves (MVs) have relied on placing the patient on cardiopulmonary bypass (on pump), stopping the heart and accessing the arrested heart directly. However, because this approach has the potential for adverse neurological, vascular, and immunological sequelae, less invasive beating heart alternatives are desirable. Emerging beating heart techniques have been developed to offer high-risk patients MV repair using ultrasound guidance alone without stopping the heart. This paper describes the first porcine trials of the NeoChord DS1000 (Minnetonka, MN), employed to attach neochordae to a MV leaflet using the traditional ultrasound-guided protocol augmented by dynamic virtual geometric models. The distance errors of the tracked tool tip from the intended midline trajectory (5.2 ± 2.4 mm versus 16.8 ± 10.9 mm, p = 0.003), navigation times (16.7 ± 8.0 s versus 92.0 ± 84.5 s, p = 0.004), and total path lengths (225.2 ± 120.3 mm versus 1128.9 ± 931.1 mm, p = 0.003) were significantly shorter in the augmented ultrasound compared to navigation with ultrasound alone, reported in this paper are also presented in a clinical context in [13]. While that paper provides the clinical context and details, the current work represents the image guidance and engineering data and analysis. indicating a substantial improvement in the safety and simplicity of the procedure.

Original languageEnglish (US)
Article number6320686
Pages (from-to)1034-1040
Number of pages7
JournalIEEE Transactions on Biomedical Engineering
Volume60
Issue number4
DOIs
StatePublished - 2013
Externally publishedYes

Keywords

  • Image-guided surgery
  • mitral valve (MV) repair
  • model-enhanced visualization
  • off-pump beating heart surgery

ASJC Scopus subject areas

  • Biomedical Engineering

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