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Accuracy evaluation of a mitral valve surgery assistance system based on optical tracking

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Mitral valve reconstruction is a widespread surgical method to repair incompetent mitral valves, which usually includes implantation of a ring prosthesis. To date, intraoperative analysis of the mitral valve is merely based on visual assessment using simple surgical tools, which might not allow for accurate assessment of the complex anatomy.

Methods

We propose a novel intraoperative computer-based assistance system, which combines passive optical tracking technology with tailored measurement strategies applicable during different phases of the intraoperative workflow. Based on the assessment of the valvular apparatus by customized tracked instruments, the system (1) generates an enhanced three-dimensional visualization, which (2) incorporates accurate quantifications and (3) provides assistance, e.g., in terms of virtual prosthesis selection.

Results

Phantom experiments in a realistic environment revealed a high system accuracy (mean precision \(0.12 \pm 0.09\) mm and mean trueness \(0.77 \pm 0.39\) mm) and a low user error (mean precision \(0.18 \pm 0.10 \) mm and mean trueness \(0.81 \pm 0.36\) mm). The assistance system was successfully applied five times during open and minimally invasive reconstructive surgery in patients having mitral valve insufficiency. The measurement steps integrate well into the traditional workflow, enhancing the surgeon’s three-dimensional perception and generating a suggestion for an appropriate prosthesis.

Conclusion

The proposed assistance system provides a novel, accurate, and reproducible method for assessing the valvular geometry intraoperatively.

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Acknowledgments

This work was carried out with support of the German Research Foundation (DFG) as part of project B01, SFB/TRR 125 Cognition-Guided Surgery. We thank the Division of fine mechanics for manufacturing the instruments and Jörg Rodrian for his technical support.

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Authors and Affiliations

  1. Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Sandy Engelhardt, Silvio Kolb, Hans-Peter Meinzer & Ivo Wolf

  2. Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany

    Raffaele De Simone, Sameer Al-Maisary & Matthias Karck

  3. Department of Computer Science, Mannheim University of Applied Science, Mannheim, Germany

    Ivo Wolf

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  1. Sandy Engelhardt
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  6. Hans-Peter Meinzer
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Correspondence to Sandy Engelhardt.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Engelhardt, S., De Simone, R., Al-Maisary, S. et al. Accuracy evaluation of a mitral valve surgery assistance system based on optical tracking. Int J CARS 11, 1891–1904 (2016). https://doi.org/10.1007/s11548-016-1353-z

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  • DOI: https://doi.org/10.1007/s11548-016-1353-z

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