MO62. Holographic Imaging/Mixed Reality in Degenerative Mitral Disease: a New Tool for a Better Understanding and Planning Operations in Complex Multi-scallops Prolapse?
IRCCS Istituto Policlinico San Donato,
SAN DONATO MILANESE, Milan
Italy - Contact Me
Graduated in 1985 Magna cum Laude at the University of Turin on Heart Transplant and assistant in the first trasplantation program in Italy in Pavia.
From 1998 to 1995 staff surgeon at Policlinico San Donato Milan , a center performing 3000 cardiac operations/year .
At ther age of 35 the youngest Chief Cardiac Surgeon in Italy with 1.200 cardiac surgery procedures/year in Turin reducing the regional waiting list form 6 months to 6 weeks with his team 'Cardioteam' . They realize total arterial revascularizations, the first videoassisted By pass presented at the World Endoscopic Surgery Congress in 1998 and Robotic surgery with the DaVinci System.
In 2008 co-founder and President of The Cardioteam Foundation Onlus ( CFO) for prevention, teaching and treatment of Cardiovascular Diseases in Italy with International training programs in Romania, Moldavia, Egypt and Georgia. CFO has realized 16.000 echocardiographic screening around Italy. Organizer of 4 international meeting and 21 national with live cases from OR at Euroecho and Eurocardiology. Presenter in 15 meeting in France, USA, Germany, China, Poland , Siria, Romania, Switzerland and North Africa .
From 2011 presenter in every Mitral Conclave edition with 18 papers and in NY an Boston as Faculty member.
Since 2019 is Chief Of Minimally Invasive and Endoscopic Surgery Dpt at IRCCS Policlinico San Donato. Milan
Consultant for Endoscopic Cardiac Surgery and member of the Scientific Committee in 'Centre Cardio-thoracique de Monaco' Montecarlo.
Has accomplished more than 14.000 cardiac operation as first operator on total arterial revascularization , Mitral and tricuspid valve repair mininvasive and totally endoscopic ( 2.450 cases) ,Minimally invasive aortic valve surgery, aortic valve sparing procedure and TAVI . He has trained more than 24 cardiac Surgeons in Italy, Romania, Moldavia, Georgia and actually in San Donato training Center.
AGENAS (National Health Agency) report for 'Cardioteam' top results in Italy.
Description
Methods: Preliminarily we evaluated the feasibility of assessing the pre-operative MV anatomy of patients using HIMR technology starting from a 256 slices CT scan. Patients undergoing MV surgery with multi-segment prolapse underwent a dynamic ECG-gated contrast enhanced CT scan. Acquired clinical images were used as an input for a new created software building a 3D patient-specific holographic reconstructions in 34 cases. Than 10 cardiac surgeons from our staff were asked to compare the HIMR imaging with the corresponding 3D intraoperative TOE by a questionnaire.
Results: The dynamic HIMR was successful reconstructed in 94% of the cases from complex degenerative mitral valve CT scan. In a subjective non quantitive evaluation all the surgeons (n 10) have confirmed a better visualization of the prolapsing scallops in HIMR mode with higher anatomical spatial definition in systole and diastole. From an objective point of view all surgeons could explored the surrounding structure : the subvalvular apparatus ( papillary muscles), the LV outflow tract and Cx artery in a real 3D mode, from different planes and perspectives ( not possible with TOE).
Conclusion: This software provided an intuitive way to fully appreciate the complex MV morphology and dynamics. Objective advantages of HIMR compared to TOE is the enhanced visualization of the valve and surrounding structures in a real 3D mode. Surgeons have the possibility to navigate into the true anatomy through a direct interaction by dynamic holograms providing a real perception of depth and spatial relationships. HIMR has the disadvantage not to be a real time technology but it is a promising new tool for surgeons and cardiologists in undertstanding and planning repair on complex mitral valve cases. Further studies are necessary to prove the real clinical advantage of this new exciting technology.