A Virtual-Reality Imaging Analysis of the Dynamic Aortic Root Anatomy

Ann Thorac Surg. 2021 Dec;112(6):2077-2083. doi: 10.1016/j.athoracsur.2021.06.038. Epub 2021 Jul 18.

Abstract

Purpose: To measure and explore complex cardiac anatomy in research and preoperative simulation, a virtual imaging technology-the Vesalius 3D suite (PS Medtech, Amsterdam, Netherlands)-combines Vesalius three-dimensional (3D) image-processing software with an optic-tracking navigation system running PST-Client software. We present a novel method of evaluating dynamic aortic root geometry in vivo using this visualization system.

Description: Based on electrocardiography-gated cardiac computed tomography data in systole and diastole, images of the aortic root in a healthy adult were reconstructed for 3D visualization. Virtual interaction tools were used to explore and measure the aortic root structures.

Evaluation: Virtually reconstructed images revealed the aortic root internal structures in exquisite detail. Highly accessible 3D interpretation promptly permitted precise measurements of repair-relevant anatomic parameters, including geometrically complex curves of the aortic root wall and dynamic changes in the aortic valves. Measurement accuracy examined against a known prosthesis showed within 1 mm of error (less than 0.5%).

Conclusions: This technology may promote understanding of aortic root form and function, and facilitate valve-sparing surgery, and seems valuable for 3D exploration and measurement of cardiac anatomy in vivo.

Publication types

  • Technical Report
  • Video-Audio Media

MeSH terms

  • Adult
  • Aortic Valve / diagnostic imaging*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnosis*
  • Aortic Valve Stenosis / surgery
  • Echocardiography, Three-Dimensional / methods*
  • Echocardiography, Transesophageal / methods*
  • Female
  • Heart Valve Prosthesis*
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Prosthesis Design
  • Reference Values
  • Retrospective Studies
  • Transcatheter Aortic Valve Replacement / methods
  • Virtual Reality*