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 with thesis on Heart Transplant. At ther age of 35 became de youngest Chief Cardiac Surgeon in Italy in a Center performing 1.200 cardiac surgery procedures/year in Turin. Since 2008 President of The Cardioteam Foundation Onlus for prevention, teaching and treatment of Cardiovascular Diseases in Italy and International programs in Romania, Moldavia, Egypt and Georgia.
Since 2019 is Chief Of Minimally Invasive and Endoscopic Surgery at IRCCS Policlinico San Donato. Milan
Consultant for Endoscopic Cardiac Surgery at ' Centre Cardio-thoracique de Monaco' Montecarlo.
He has accomplished more than 14.000 cardiac operation as firsr surgeon, total arterial coronary revascularization, Mitral and tricuspid valve repair mininvasive and endoscopic, Minimally invasive aortic valve surgery, aortic valve sparing procedure and TAVI .
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.