TY - JOUR
T1 - A navigation platform for guidance of beating heart transapical mitral valve repair
AU - Moore, John T.
AU - Chu, Michael W.A.
AU - Kiaii, Bob
AU - Bainbridge, Daniel
AU - Guiraudon, Gerard
AU - Wedlake, Chris
AU - Currie, Maria
AU - Rajchl, Martin
AU - Patel, Rajni V.
AU - Peters, Terry M.
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - Image-guided surgery
KW - mitral valve (MV) repair
KW - model-enhanced visualization
KW - off-pump beating heart surgery
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U2 - 10.1109/TBME.2012.2222405
DO - 10.1109/TBME.2012.2222405
M3 - Article
C2 - 23047858
AN - SCOPUS:84875530349
VL - 60
SP - 1034
EP - 1040
JO - IEEE Transactions on Biomedical Engineering
JF - IEEE Transactions on Biomedical Engineering
SN - 0018-9294
IS - 4
M1 - 6320686
ER -