Bruckheimer Elchanan, Lowenthal Alexander, Schamroth Pravda Nili, Vaknin-Assa Hana, Vaturi Mordehay, Amir Gabriel, Perl Leor, Codner Pablo, Shapira Yaron, Dagan Tamir, Kornowski Ran, Birk Einat
Department of Pediatric Cardiology, Schneider Children's Medical Center of Israel affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Cardiology, Rabin Medical Center, Petach Tikva, affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
CJC Open. 2025 Mar 24;7(6):728-735. doi: 10.1016/j.cjco.2025.03.014. eCollection 2025 Jun.
Real-time 3-dimensional transesophageal echocardiography (3DTEE) data acquired during interventional procedures are displayed on 2-dimensional screens, limiting intuitive depth perception and spatial comprehension. The study objectives were to evaluate the feasibility of intraprocedural use of a holography display during structural cardiology procedures employing 3DTEE, and to assess the accuracy of offline linear measurements in 3DTEE datasets.
A prospective single-center study was conducted using the HOLOSCOPE-i to guide catheter-based procedures using intraprocedural 3DTEE. Qualitative measures of recognition of anatomic structures, 3D spatial comprehension, and interaction with intracardiac anatomic structures and catheter position were evaluated using a Likert scale. Additionally, a retrospective analysis of offline 3DTEE datasets of mitral valve measurements were performed using the HOLOSCOPE-i vs QLAB. Intra- and interobserver variability was assessed, assuming an intraclass correlation coefficient > 0.75 indicates adequate reliability.
A total of 13 patients were enrolled. In all cases, anatomic structures were identified in real time, and spatial comprehension was enhanced (Likert scale). No nausea or headache was reported by the operators. Retrospective analysis of 41 mitral valve 3DTEE datasets was performed. Annular diameter measurements (anteroposterior [AP] and anterolateral-posteromedial [AL-PM]) demonstrated a Pearson correlation of 0.89 (HOLOSCOPE-i) and 0.91 (QLAB). Intraobserver ICC for AP, AL-PM was 0.97, 0.94 (HOLOSCOPE-i) and 0.95, 0.97 (QLAB); interobserver ICC for AP and AL-PM was 0.77 and 0.88 (HOLOSCOPE-i) and 0.96 and 0.98 (QLAB).
Holographic display of intraprocedural real-time 3DTEE data is feasible and augments the experience of the operator. Linear measurements in the 3D holographic display are accurate, with good correlation to those using 2-dimensional multiplanar reconstruction 3DTEE software.
MOH_2021-09-13_010255.
介入手术过程中获取的实时三维经食管超声心动图（3DTEE）数据显示在二维屏幕上，限制了直观的深度感知和空间理解。本研究的目的是评估在采用3DTEE的结构性心脏病手术中术中使用全息显示的可行性，并评估3DTEE数据集中离线线性测量的准确性。
使用HOLOSCOPE-i进行前瞻性单中心研究，以指导基于导管的手术，并在术中使用3DTEE。使用李克特量表评估对解剖结构的识别、三维空间理解以及与心内解剖结构和导管位置的交互的定性指标。此外，使用HOLOSCOPE-i与QLAB对二尖瓣测量的离线3DTEE数据集进行回顾性分析。评估观察者内和观察者间的变异性，假设组内相关系数>0.75表示可靠性良好。
共纳入13例患者。在所有病例中，均实时识别了解剖结构，并增强了空间理解（李克特量表）。操作者未报告恶心或头痛。对41个二尖瓣3DTEE数据集进行了回顾性分析。瓣环直径测量（前后径[AP]和前外侧-后内侧径[AL-PM]）显示Pearson相关性为0.89（HOLOSCOPE-i）和0.91（QLAB）。观察者内AP、AL-PM的组内相关系数分别为0.97、0.94（HOLOSCOPE-i）和0.95、0.97（QLAB）；观察者间AP和AL-PM的组内相关系数分别为0.77和0.88（HOLOSCOPE-i）以及0.96和0.98（QLAB）。
术中实时3DTEE数据的全息显示是可行的，并增强了操作者的体验。三维全息显示中的线性测量准确，与使用二维多平面重建3DTEE软件的测量具有良好的相关性。
MOH_2021-09-13_010255。
