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Proceedings Paper

Computer-assisted LAD bypass grafting at the open heart
Author(s): Christine Hartung; Claudia Gnahm; Reinhard Friedl; Martin Hoffmann; Klaus Dietmayer
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Paper Abstract

Open heart bypass surgery is the standard treatment in advanced coronary heart diseases. For an effective revascularization procedure, optimal placement of the bypass is very important. To accelerate the intraoperative localization of the anastomosis site and to increase the precision of the procedure, a concept for computer assistance in open heart bypass surgery has been developed comprising the following steps: 1. Preprocedural planning: A patient-specific coronary map with information on vessel paths and wall plaque formations is extracted from a multi-slice computed tomography (MSCT). On this basis, the heart surgeon and the cardiac radiologist define the optimal anastomosis site prior to surgery. 2. Intraoperative navigation: During surgery, data are recorded at the beating heart using a stereo camera system. After registering the pre- and intraoperative data sets, preprocedural information can be transferred to the surgical site by overlaying the coronary map and the planned anastomosis site on the live video stream. With this visual guidance system, the surgeon can navigate to the planned anastomosis site. In this work, the proposed surgical assistance system has been validated for the left anterior descending coronary artery (LAD). The accuracy of the registration mechanism has been evaluated in retrospective on patient data sets and the effects of breathing motion were quantified. The promising results of the retrospective evaluation led to the in-vivo application of the computer assistance system during several bypass grafting procedures. Intraoperative navigation has been performed successfully and postoperative evaluation confirms that the bypass grafts were accurately positioned to the preoperatively planned anastomosis sites.

Paper Details

Date Published: 13 March 2009
PDF: 9 pages
Proc. SPIE 7261, Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling, 72610P (13 March 2009); doi: 10.1117/12.813850
Show Author Affiliations
Christine Hartung, Univ. of Ulm (Germany)
Claudia Gnahm, Univ. of Ulm (Germany)
Reinhard Friedl, Univ. Hospitals of Ulm and Lübeck (Germany)
Martin Hoffmann, Univ. Hospital of Ulm (Germany)
Klaus Dietmayer, Univ. of Ulm (Germany)

Published in SPIE Proceedings Vol. 7261:
Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling
Michael I. Miga; Kenneth H. Wong, Editor(s)

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