Congenital heart: How often does VR change the surgical plan?

“VR reconstruction in seven patients out of ten (70%)”

7 of 10 patients (70%)

“Anatomic digital twins changed the initially decided upon surgical strategies for 68% of cases.”

68%

“All 9 patients in the 3D group were operated only through a median sternotomy, while 8 cases (72.7%) needed another posterolateral thoracotomy in the conventional group, which was statistically different ( p = 0.001).”

p = 0.001

“improved in four cases with the use of the physical 3D printed model and in five cases using the VR setup, changing the surgical plan from univentricular to biventricular repair”

“In another case, VR reconstruction identified a persistent vertical vein connecting the left superior vena cava and the left atrium, providing essential anatomical insight for planning both DA stenting and static atrial septostomy as the first stage of palliation for a complex congenital defect”

“Modelling may help evaluate transcatheter pulmonary valve replacement candidacy, but must be used in conjunction with other data.”

“After viewing patient cases on VR, surgeons reported that they would have made minor modifications to surgical approach in 53% and major modifications in 7% of cases.”

53%

“In addition, surgical planning was improved since new observations or different preoperative plans were apparent in 4 out of 7 cases.”

4 out of 7

“Among surgeons and interventionalists, 82% reported improved procedural planning and 57% altered their procedural approach.”

57%

“model simulated a virtual biventricular repair and demonstrated inadequate outflow tracts after patching and baffle”

“As the VR reconstructions had suggested an irregular shape of the orifices earlier, the detection of residual flows above the caudally placed muscular VSD device immediately allowed us to switch to plan B, using a sandwich between two occluders”

“was initially considered for the single-ventricle pathway. However, preoperative evaluation using a holographic workstation enabled precise ventricular volume assessment and intraventricular rerouting simulation. A virtual baffle confirmed the feasibility of biventricular repair.”

“which were useful to plan valve implantation with a modified technique”

“Virtual reality imaging aided visualisation, decision-making, and planning.”

“Patient 1 was not felt to be a candidate for HVAD implantation, because during VR placement of the pump within the chest, the pump inflow would have been located within the system AV valve annulus.”

“After using our system, the surgeons experienced an increase in their confidence regarding the surgical approach in two thirds of the cases and reported that they would have modified their original plan in 60% of the cases.”

60% of cases

“We could confirm that the inflow cannula will not impinge on the mitral valve. He was hence offered an LVAD implant.”

“Viewing the models in virtual reality allowed the team to precisely locate the defects and decide on a hybrid transcatheter and surgical approach to ensure successful repair.”