Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, the Netherlands.
World J Pediatr Congenit Heart Surg. 2021 Nov;12(6):765-772. doi: 10.1177/21501351211045064. Epub 2021 Nov 23.
Major aortopulmonary collateral arteries (MAPCAs), as seen in patients with pulmonary atresia, are arteries that supply blood from the aorta to the lungs and often require surgical intervention. To achieve complete repair in the least number of interventions, optimal imaging of the pulmonary arterial anatomy and MAPCAs is critical. 3D virtual reality (3D-VR) is a promising and upcoming new technology that could potentially ameliorate current imaging shortcomings.
A retrospective, proof-of-concept study was performed of all operated patients with pulmonary atresia and MAPCAs at our center between 2010 and 2020 with a preoperative computed tomography (CT) scan. CT images were reviewed by two congenital cardiac surgeons in 3D-VR to determine additional value of VR for MAPCA imaging compared to conventional CT and for preoperative planning of MAPCA repair.
3D-VR visualizations were reconstructed from CT scans of seven newborns where the enhanced topographic anatomy resulted in improved visualization of MAPCA. In addition, surgical planning was improved since new observations or different preoperative plans were apparent in 4 out of 7 cases. After the initial setup, VR software and hardware was reported to be easy and intuitive to use.
This study showed technical feasibility of 3D-VR reconstruction of children with immersive visualization of topographic anatomy in an easy-to-use format leading to an improved surgical planning of MAPCA surgery. Future prospective studies are required to investigate the clinical benefits in larger populations.
在肺动脉闭锁患者中可见到主要体肺侧支动脉（MAPCAs），这些动脉从主动脉向肺部供血，通常需要手术干预。为了在最少的干预次数下实现完全修复，对肺动脉解剖结构和 MAPCAs 的最佳成像至关重要。3D 虚拟现实（3D-VR）是一种很有前途的新技术，有可能改善当前的成像缺陷。
回顾性分析了 2010 年至 2020 年期间在我院接受手术治疗的所有合并 MAPCAs 的肺动脉闭锁患者的资料，所有患者术前均行 CT 扫描。两名先天性心脏外科医生在 3D-VR 中对 CT 图像进行了复查，以确定 VR 在 MAPCA 成像方面相对于常规 CT 的额外价值，以及用于 MAPCA 修复的术前规划。
从 7 例新生儿的 CT 扫描中重建了 3D-VR 可视化图像，增强的拓扑解剖结构改善了 MAPCA 的可视化效果。此外，4 例中的 7 例有新的观察结果或不同的术前计划，从而改善了手术计划。初始设置后，VR 软件和硬件被报告为易于使用和直观。
本研究表明，3D-VR 重建具有技术可行性，可对儿童进行沉浸式拓扑解剖可视化，易于使用，可改善 MAPCA 手术的手术计划。需要进一步进行前瞻性研究，以在更大的人群中调查其临床获益。
