Abstract
Purpose In this paper, we propose a pilot study for transcatheter aortic valve implantation guided by an augmented magnetic tracking system (MTS) with a dynamic aortic model and intra-operative ultrasound (US) images. Methods The dynamic 3D aortic model is constructed from the preoperative 4D computed tomography, which is animated according to the real-time electrocardiograph (ECG) input of patient. Before the procedure, the US probe calibration is performed to map the US image coordinate to the tracked device coordinate. A temporal alignment is performed to synchronize the ECG signals, the intra-operative US image and the tracking information. Thereafter, with the assistance of synchronized ECG signals, the spatial registration is performed by using a feature-based registration. Then the augmented MTS guides the surgeon to confidently position and deploy the transcatheter aortic valve prosthesis to the target.
Results The approach was validated by US probe calibration evaluation and animal study. The US calibration accuracy achieved \(1.37\pm 0.43\, \text{ mm}\), whereas in the animal study on three porcine subjects, fiducial, target, deployment distance and tilting errors reached \(3.16\pm 0.55\,\text{ mm}\), \(3.80\pm 1.83\,\text{ mm}\), \(3.13\pm 1.12\,\text{ mm}\) and \(5.87\pm 2.35^{\circ }\), respectively.
Conclusion Our pilot study has revealed that the proposed approach is feasible and accurate for delivery and deployment of transcatheter aortic valve prosthesis.
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Acknowledgments
This research work is partially supported by the Chinese NSFC research fund (61190120, 61190124 and 61271318), the Shanghai municipal health bureau research fund (2011216) and Biomedical engineering fund of Shanghai Jiaotong University (YG201 2MS21). The authors are grateful to the radiologists from Zhongshan Hospital for their support in animal imaging and animal surgery as well as to MicroPort Co., Ltd. for providing and renewing cannula, transcatheter and aortic valve prosthesis for MTS guidance purpose.
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Luo, Z., Cai, J. & Gu, L. A pilot study on magnetic navigation for transcatheter aortic valve implantation using dynamic aortic model and US image guidance. Int J CARS 8, 677–690 (2013). https://doi.org/10.1007/s11548-012-0809-z
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DOI: https://doi.org/10.1007/s11548-012-0809-z