Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy.
Heart Valve Center, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.
Int J Cardiol. 2024 Oct 1;412:132330. doi: 10.1016/j.ijcard.2024.132330. Epub 2024 Jul 2.
BACKGROUND: Using three-dimensional (3D) modalities for optimal pre-procedure planning in transcatheter aortic valve replacement (TAVR) is critical for procedural success. However, current methods rely on visualizing images on a two-dimensional screen, using shading and colors to create the illusion of 3D, potentially impeding the accurate comprehension of the actual anatomy structures. In contrast, a new Mixed Reality (MxR) based software enables accurate 3D visualization, imaging manipulation, and quantification of measurements. AIMS: The study aims to evaluate the feasibility, reproducibility, and accuracy of dimensions of the aortic valve complex as measured with a new holographic MxR software (ARTICOR®, Artiness srl, Milano, Italy) compared to a widely used software for pre-operative sizing and planning (3mensio Medical Imaging BV, Bilthoven, The Netherlands). METHODS: This retrospective, observational, double-center study enrolled 100 patients with severe aortic stenosis who underwent cardiac computed tomography (CCT) before TAVR. The CCT datasets of volumetric aortic valve images were analyzed using 3Mensio and newly introduced MxR-based software. RESULTS: Ninety-eight percent of the CCT datasets were successfully converted into holographic models. A higher level of agreement between the two software systems was observed for linear metrics (short, long, and average diameter). In comparison, agreement was lower for area, perimeter, and annulus-to-coronary ostia distance measurements. Notably, the annulus area, annular perimeter, left ventricular outflow tract (LVOT) area, and LVOT perimeter were significantly and consistently smaller with the MxR-based software compared to the 3Mensio. Excellent interobserver reliability was demonstrated for most measurements, especially for direct linear measurements. CONCLUSIONS: Linear measurements of the aortic valve complex using MxR-based software are reproducible compared to the standard CCT dataset analyzed with 3Mensio. MxR-based software could represent an accurate tool for the pre-procedural planning of TAVR.
背景：在经导管主动脉瓣置换术（TAVR）中，使用三维（3D）模式进行最佳术前规划对于手术成功至关重要。然而，目前的方法依赖于在二维屏幕上可视化图像，使用阴影和颜色来创建 3D 的错觉，可能会阻碍对实际解剖结构的准确理解。相比之下，一种新的基于混合现实（MxR）的软件可以实现准确的 3D 可视化、图像操作和测量量化。
目的：本研究旨在评估一种新的全息 MxR 软件（ARTICOR ® ，Artiness srl，米兰，意大利）测量主动脉瓣复合体的尺寸的可行性、可重复性和准确性，与一种广泛用于术前评估和规划的软件（3mensio Medical Imaging BV，比托霍芬，荷兰）进行比较。
方法：这项回顾性、观察性、双中心研究纳入了 100 例接受 TAVR 前心脏计算机断层扫描（CCT）的严重主动脉瓣狭窄患者。使用 3mensio 和新引入的基于 MxR 的软件对容积主动脉瓣图像的 CCT 数据集进行分析。
结果：98%的 CCT 数据集成功转换为全息模型。两种软件系统的线性测量值（短、长和平均直径）之间的一致性更高。相比之下，面积、周长和瓣环到冠状动脉口距离的测量值的一致性较低。值得注意的是，与 3mensio 相比，基于 MxR 的软件测量的瓣环面积、瓣环周长、左心室流出道（LVOT）面积和 LVOT 周长明显更小。大多数测量值的观察者间可靠性都很好，尤其是直接线性测量值。
结论：与使用 3mensio 分析的标准 CCT 数据集相比，基于 MxR 的软件测量主动脉瓣复合体的线性测量值具有可重复性。基于 MxR 的软件可能成为 TAVR 术前规划的准确工具。
Int J Cardiol. 2024-10-1
JACC Cardiovasc Interv. 2013-8-14
Interact Cardiovasc Thorac Surg. 2017-8-1
Eur Heart J Digit Health. 2025-3-25
Zotero 插件