Augmented-reality computed tomography-guided transcatheter pacemaker implantation in dextrocardia and congenitally corrected transposition of great arteries

Current and Future Applications of Virtual, Augmented, and Mixed Reality in Cardiothoracic Surgery

“…Also a case report was published to demonstrate that AR could help to guide a challenging transvenous approach for pacemaker implantation in a patient with congenitally corrected transposition of great arteries and dextrocardia. 19 Intraoperative Guidance: Thoracic A study by Rouze and coworkers 20 described an intraoperative guidance technique using cone-beam CT for small pulmonary nodule localization to direct lung resection during video-assisted thoracoscopic surgery with augmented fluoroscopy overprojecting the real-time surgical field. A preprocedural 3D reconstruction of the lung nodules was performed in 8 patients based on conebeam CT images, which were converted into augmented fluoroscopic images overprojecting the video-assisted thoracic procedure to guide the surgeon in locating the targeted nodules.…”

The Expanding Uses of Medical Extended Reality in the Cardiac Catheterization Laboratory: Pre-procedural Planning, Intraprocedural Guidance, and Intraprocedural Navigation

“…A 2018 case report from Poland describes the use of AR for assistance with leadless transvenous pacemaker implantation in a patient with dextrocardia, congenitally corrected transposition of the great arteries status post ventricular septal defect repair who developed complete heart block. 22 3D reconstructed images of a CTA were displayed using a Google Glass head-mounted display and oriented in a similar angle as the fluoroscopic views from the C-arm in the catheterization lab. This allowed the clinical operator to identify the most 'optimal' orientation for visualizing the trajectory of the leadless pacemaker as it was positioned into the ventricle.…”

“…Although only one patient was included in this case report, it showed that AR may be useful in the planning of leadless pacemaker implantation procedures when anatomy is ill defined, complex, or surgically altered. 22 A larger, comprehensive randomized study assessing AR assisted pacemaker implantation (both lead implant and leadless pacemakers) versus fluoroscopic guidance alone would be an appropriate next step in understanding how XR technologies can improve device implantation cases.…”

Advanced Medical Use of Three-Dimensional Imaging in Congenital Heart Disease: Augmented Reality, Mixed Reality, Virtual Reality, and Three-Dimensional Printing

“…Another study demonstrated that augmented reality using ECG-gated CT data facilitated transcatheter heart valve implantation during valve-in-valve procedures while using less contrast agent (27). In a patient with congenitally corrected transposition of the great arteries, augmented reality was used to guide transcatheter pacemaker implantation (28). Mixed reality using HoloLens® has helped surgeons understand the complex morphologies of CHD (29).…”