Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany.
Heartcenter Trier Krankenhaus der Barmherzigen Brueder Trier Germany.
J Am Heart Assoc. 2024 Aug 6;13(15):e034086. doi: 10.1161/JAHA.123.034086. Epub 2024 Jul 23.
Detailed visualization and precise measurements of aortic valve dimensions are critical for the success of transcatheter aortic valve implantation and for the prevention of complications. Currently, multislice computed tomography is the gold standard for assessment of the aortic annulus and surrounding structures to determine the prosthesis size. New technologies such as virtual reality (VR) not only enable 3-dimensional (3D) visualization with the potential to improve understanding of anatomy and pathology but also allow measurements in 3D. This study aims to investigate the feasibility, accuracy, and reproducibility of VR for the visualization of the aortic valve, the surrounding structures, and its role in preprocedural sizing for transcatheter aortic valve implantation.
Based on the preprocedural multislice computed tomography data, 3mensio measurements and 3D visualizations and measurements using VR software were performed retrospectively on 60 consecutive patients who underwent transcatheter aortic valve implantation at our heart center. There were no significant differences but strong correlations between the VR measurements compared with those performed with the 3mensio software. Furthermore, excellent or good intra- and interobserver reliability could be demonstrated for all values. In a structured questionnaire, users reported that VR simplified anatomical understanding, improved 3D comprehension of adjacent structures, and was associated with very good self-perceived depth perception.
The use of VR for preprocedural transcatheter aortic valve implantation sizing is feasible and has precise and reproducible measurements. In addition, 3D visualization improves anatomical understanding and orientation. To evaluate the potential benefits of 3D visualization for planning further cardiovascular interventions, research in this field is needed.
详细的可视化和精确的主动脉瓣尺寸测量对于经导管主动脉瓣植入术的成功以及预防并发症至关重要。目前，多层计算机断层扫描是评估主动脉瓣环和周围结构以确定假体尺寸的金标准。虚拟现实（VR）等新技术不仅能够进行 3 维（3D）可视化，有可能改善对解剖和病理学的理解，而且还允许进行 3D 测量。本研究旨在探讨 VR 用于可视化主动脉瓣、周围结构及其在经导管主动脉瓣植入术术前 sizing 中的作用的可行性、准确性和可重复性。
基于术前多层计算机断层扫描数据，对在我们心脏中心接受经导管主动脉瓣植入术的 60 例连续患者进行了 3mensio 测量和 VR 软件的 3D 可视化和测量。与 3mensio 软件相比，VR 测量值之间没有显著差异，但具有很强的相关性。此外，所有值的内部和观察者间的可靠性均表现出色或良好。在一个结构化的问卷调查中，用户报告说 VR 简化了解剖学理解，改善了对相邻结构的 3D 理解，并且具有非常好的自我感知深度知觉。
在经导管主动脉瓣植入术术前 sizing 中使用 VR 是可行的，并且具有精确和可重复的测量值。此外，3D 可视化可改善解剖学理解和方向。为了评估 3D 可视化在规划进一步心血管介入治疗中的潜在益处，需要在该领域进行研究。
