Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective

Objectives: To investigate how virtual reality (VR) imaging impacts decision-making in atrioventricular valve surgery. Methods: This was a single-center retrospective study involving 15 children and adolescents, median age 6 years (range, 0.33-16) requiring surgical repair of the atrioventricular va...

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Main Authors: Kuberan Pushparajah, MD, MRCPCH, Ka Yee Kelly Chu, Shujie Deng, PhD, Gavin Wheeler, PhD, Alberto Gomez, PhD, Saleha Kabir, PhD, Julia A. Schnabel, PhD, MSc, MA, John M. Simpson, MD, FRCP
Format: Article
Language:English
Published: Elsevier 2021-06-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250721001991
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author Kuberan Pushparajah, MD, MRCPCH
Ka Yee Kelly Chu
Shujie Deng, PhD
Gavin Wheeler, PhD
Alberto Gomez, PhD
Saleha Kabir, PhD
Julia A. Schnabel, PhD, MSc, MA
John M. Simpson, MD, FRCP
author_facet Kuberan Pushparajah, MD, MRCPCH
Ka Yee Kelly Chu
Shujie Deng, PhD
Gavin Wheeler, PhD
Alberto Gomez, PhD
Saleha Kabir, PhD
Julia A. Schnabel, PhD, MSc, MA
John M. Simpson, MD, FRCP
author_sort Kuberan Pushparajah, MD, MRCPCH
collection DOAJ
description Objectives: To investigate how virtual reality (VR) imaging impacts decision-making in atrioventricular valve surgery. Methods: This was a single-center retrospective study involving 15 children and adolescents, median age 6 years (range, 0.33-16) requiring surgical repair of the atrioventricular valves between the years 2016 and 2019. The patients' preoperative 3-dimesnional (3D) echocardiographic data were used to create 3D visualization in a VR application. Five pediatric cardiothoracic surgeons completed a questionnaire formulated to compare their surgical decisions regarding the cases after reviewing conventionally presented 2-dimesnional and 3D echocardiographic images and again after visualization of 3D echocardiograms using the VR platform. Finally, intraoperative findings were shared with surgeons to confirm assessment of the pathology. Results: In 67% of cases presented with VR, surgeons reported having “more” or “much more” confidence in their understanding of each patient's pathology and their surgical approach. In all but one case, surgeons were at least as confident after reviewing the VR compared with standard imaging. The case where surgeons reported to be least confident on VR had the worst technical quality of data used. 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. Conclusions: The main impact of viewing imaging on VR is the improved clarity of the anatomical structures. Surgeons reported that this would have impacted the surgical approach in the majority of cases. Poor-quality 3D echocardiographic data were associated with a negative impact of VR visualization; thus. quality assessment of imaging is necessary before projecting in a VR format.
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spelling doaj-art-5b97bb9ca74349478f22f034f57d26692025-08-20T03:38:26ZengElsevierJTCVS Techniques2666-25072021-06-01726927710.1016/j.xjtc.2021.02.044Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspectiveKuberan Pushparajah, MD, MRCPCH0Ka Yee Kelly Chu1Shujie Deng, PhD2Gavin Wheeler, PhD3Alberto Gomez, PhD4Saleha Kabir, PhD5Julia A. Schnabel, PhD, MSc, MA6John M. Simpson, MD, FRCP7School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom; Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom; Address for reprints: Kuberan Pushparajah, MD, MRCPCH, School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, 3rd Floor Lambeth Wing, London, SE1 7EH United Kingdom.School of Biomedical Engineering & Imaging Sciences, King's College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, United KingdomDepartment of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, United KingdomSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom; Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, United KingdomObjectives: To investigate how virtual reality (VR) imaging impacts decision-making in atrioventricular valve surgery. Methods: This was a single-center retrospective study involving 15 children and adolescents, median age 6 years (range, 0.33-16) requiring surgical repair of the atrioventricular valves between the years 2016 and 2019. The patients' preoperative 3-dimesnional (3D) echocardiographic data were used to create 3D visualization in a VR application. Five pediatric cardiothoracic surgeons completed a questionnaire formulated to compare their surgical decisions regarding the cases after reviewing conventionally presented 2-dimesnional and 3D echocardiographic images and again after visualization of 3D echocardiograms using the VR platform. Finally, intraoperative findings were shared with surgeons to confirm assessment of the pathology. Results: In 67% of cases presented with VR, surgeons reported having “more” or “much more” confidence in their understanding of each patient's pathology and their surgical approach. In all but one case, surgeons were at least as confident after reviewing the VR compared with standard imaging. The case where surgeons reported to be least confident on VR had the worst technical quality of data used. 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. Conclusions: The main impact of viewing imaging on VR is the improved clarity of the anatomical structures. Surgeons reported that this would have impacted the surgical approach in the majority of cases. Poor-quality 3D echocardiographic data were associated with a negative impact of VR visualization; thus. quality assessment of imaging is necessary before projecting in a VR format.http://www.sciencedirect.com/science/article/pii/S2666250721001991virtual realitycongenital heart diseasesurgeryatrioventricular valvesevolving technology
spellingShingle Kuberan Pushparajah, MD, MRCPCH
Ka Yee Kelly Chu
Shujie Deng, PhD
Gavin Wheeler, PhD
Alberto Gomez, PhD
Saleha Kabir, PhD
Julia A. Schnabel, PhD, MSc, MA
John M. Simpson, MD, FRCP
Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
JTCVS Techniques
virtual reality
congenital heart disease
surgery
atrioventricular valves
evolving technology
title Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
title_full Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
title_fullStr Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
title_full_unstemmed Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
title_short Virtual reality three-dimensional echocardiographic imaging for planning surgical atrioventricular valve repairCentral MessagePerspective
title_sort virtual reality three dimensional echocardiographic imaging for planning surgical atrioventricular valve repaircentral messageperspective
topic virtual reality
congenital heart disease
surgery
atrioventricular valves
evolving technology
url http://www.sciencedirect.com/science/article/pii/S2666250721001991
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