Imaging Research Laboratories, Robarts Research Institute, 100 Perth Dr., P.O. Box 5015, London, ON, N6A 5K8, Canada.
Int J Comput Assist Radiol Surg. 2009 Mar;4(2):113-23. doi: 10.1007/s11548-008-0278-6. Epub 2008 Nov 15.
An interventional system for minimally invasive cardiac surgery was developed for therapy delivery inside the beating heart, in absence of direct vision.
A system was developed to provide a virtual reality (VR) environment that integrates pre-operative imaging, real-time intra-operative guidance using 2D trans-esophageal ultrasound, and models of the surgical tools tracked using a magnetic tracking system. Detailed 3D dynamic cardiac models were synthesized from high-resolution pre-operative MR data and registered within the intra-operative imaging environment. The feature-based registration technique was employed to fuse pre- and intra-operative data during in vivo intracardiac procedures on porcine subjects.
This method was found to be suitable for in vivo applications as it relies on easily identifiable landmarks, and hence, it ensures satisfactory alignment of pre- and intra-operative anatomy in the region of interest (4.8 mm RMS alignment accuracy) within the VR environment. Our initial experience in translating this work to guide intracardiac interventions, such as mitral valve implantation and atrial septal defect repair demonstrated feasibility of the methods.
Surgical guidance in the absence of direct vision and with no exposure to ionizing radiation was achieved, so our virtual environment constitutes a feasible candidate for performing various off-pump intracardiac interventions.
开发了一种用于微创心脏手术的介入系统，以便在没有直接视野的情况下在跳动的心脏内进行治疗。
开发了一个系统，提供了一个虚拟现实（VR）环境，该环境集成了术前成像、使用二维经食管超声实时进行的术中引导，以及使用磁跟踪系统跟踪的手术工具模型。从高分辨率的术前磁共振数据综合出详细的 3D 动态心脏模型，并在术中成像环境中进行注册。基于特征的配准技术用于在活体心内手术期间融合术前和术中数据。
该方法适用于活体应用，因为它依赖于易于识别的标记，因此可以确保在 VR 环境中在感兴趣区域（4.8mm RMS 对准精度）中满意地对准术前和术中解剖结构。我们将这项工作转化为指导心内介入的初步经验，例如二尖瓣植入和房间隔缺损修复，证明了这些方法的可行性。
在没有直接视野且不接触电离辐射的情况下实现了手术引导，因此我们的虚拟环境构成了进行各种非体外循环心内介入的可行候选方案。
