Augmented Reality Image Guidance Improves Navigation for Beating Heart Mitral Valve Repair

Chu, Michael; Moore, John; Peters, Terry M.; Bainbridge, Daniel; McCarty, David; Guiraudon, G; Wedlake, Chris; Lang, Pencilla; Rajchl, Martin; Currie, Morgan; Daly, Richard C.; Kiaii, Bob

doi:10.1097/imi.0b013e31827439ea

Cited by 27 publications

(10 citation statements)

References 23 publications

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“…Within healthcare, ARAs have been developed to train or educate medical professionals [21], as a navigation tool during surgical procedures [22, 23] to enhance visualization at the operating room [24] and as a therapeutic tool in the treatment of patients [25–27]. …”

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confidence: 99%

Systematic review on the effectiveness of augmented reality applications in medical training

2016

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BackgroundComputer-based applications are increasingly used to support the training of medical professionals. Augmented reality applications (ARAs) render an interactive virtual layer on top of reality. The use of ARAs is of real interest to medical education because they blend digital elements with the physical learning environment. This will result in new educational opportunities. The aim of this systematic review is to investigate to which extent augmented reality applications are currently used to validly support medical professionals training.MethodsPubMed, Embase, INSPEC and PsychInfo were searched using predefined inclusion criteria for relevant articles up to August 2015. All study types were considered eligible. Articles concerning AR applications used to train or educate medical professionals were evaluated.ResultsTwenty-seven studies were found relevant, describing a total of seven augmented reality applications. Applications were assigned to three different categories. The first category is directed toward laparoscopic surgical training, the second category toward mixed reality training of neurosurgical procedures and the third category toward training echocardiography. Statistical pooling of data could not be performed due to heterogeneity of study designs. Face-, construct- and concurrent validity was proven for two applications directed at laparoscopic training, face- and construct validity for neurosurgical procedures and face-, content- and construct validity in echocardiography training. In the literature, none of the ARAs completed a full validation process for the purpose of use.ConclusionAugmented reality applications that support blended learning in medical training have gained public and scientific interest. In order to be of value, applications must be able to transfer information to the user. Although promising, the literature to date is lacking to support such evidence.

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confidence: 99%

Systematic review on the effectiveness of augmented reality applications in medical training

2016

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“…Essential components that are prerequisite for establishing a simulation-based learning curriculum include having appropriate infrastructure, protected time for both trainees and teachers, regular simulation participation distributed over time, and a validated method to monitor performance (McGaghie et al, 2011;Gardner et al, 2015;Andersen et al, 2018). Simulation technology has been applied in many surgical disciplines as an adjunct to clinical training, using a variety of component task trainers, animal tissue-based simulators, and computer-aided simulation models (Friedl et al, 2002;Gallagher et al, 2004;Aggarwal et al, 2006;Chu et al, 2012;Trehan et al, 2014;Liu et al, 2015;Valdis et al, 2015Valdis et al, , 2016Mafeld et al, 2017;Korzeniowski et al, 2018;Ruikar et al, 2018;Patel et al, 2019). Cadaveric simulation has likewise been utilized in several non-thoracic specialties, with varying degrees of sophistication, whole body or component parts, and on occasion in combination with another model (Jackson et al, 2003;Güvençer et al, 2007;Ghanem et al, 2013;Carey et al, 2014;Ahmed et al, 2015;Benet et al, 2015;Egle et al, 2015;Camp et al, 2016;Sharma et al, 2016;Burns et al, 2017;Robinson et al, 2017;Willaert et al, 2018;Yiasemidou et al, 2018;Zada et al, 2018).…”

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confidence: 99%

Cadaveric Simulation Training in Cardiothoracic Surgery: A Systematic Review

Robinson

Piekut

Hasman

et al. 2019

Anatomical Sciences Ed

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Simulation training has become increasingly relevant in the educational curriculum of surgical trainees. The types of simulation models used, goals of simulation training, and an objective assessment of its utility and effectiveness are highly variable. The role and effectiveness of cadaveric simulation in cardiothoracic surgical training has not been well established. The objective of this study was to evaluate the current medical literature available on the utility and the effectiveness of cadaveric simulation in cardiothoracic surgical residency training. A literature search was performed using PubMed, Cochrane Library, Embase, Scopus, and CINAHL from inception to February 2019. Of the 362 citations obtained, 23 articles were identified and retrieved for full review, yielding ten eligible articles that were included for analysis. One additional study was identified and included in the analysis. Extraction of data from the selected articles was performed using predetermined data fields, including study design, study participants, simulation task, performance metrics, and costs. Most of these studies were only descriptive of a cadaveric or perfused cadaveric simulation model that could be used to augment clinical operative training in cardiothoracic surgery. There is a paucity of evidence in the literature that specifically evaluates the utility and the efficacy of cadavers in cardiothoracic surgery training. Of the few studies that have been published in the literature, cadaveric simulation does seem to have a role in cardiothoracic surgery training beyond simply learning basic skills. Additional research in this area is needed. Anat Sci Educ 13: 406-418.

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“…Through the use of this guidance system for mitral valve repair, we found that simply defining the valve annuli from tracked TEE was sufficient for image guidance and eliminated the need for complex preoperative models and registrations with associated errors. 14,15 Using this guidance system, the surgeon can easily and intuitively identify the tool, surgical targets, and high-risk areas.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, previous work using AR and TEE for beating heart mitral valve repair has found that simply defining the valve annuli from tracked TEE is sufficient for image guidance. 14,15 This eliminates the need for complex preoperative models and registrations with associated errors. 16,17 We have adopted this AR and TEE guidance system for TAVI deployment.…”

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Augmented Reality System for Ultrasound Guidance of Transcatheter Aortic Valve Implantation

Currie

McLeod

Moore

et al. 2016

Innovations�(Phila)

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Objective Transcatheter aortic valve implantation (TAVI) relies on fluoroscopy and nephrotoxic contrast medium for valve deployment. We propose an alternative guidance system using augmented reality (AR) and transesophageal echocardiography (TEE) to guide TAVI deployment. The goals of this study were to determine how consistently the aortic valve annulus is defined from TEE using different aortic valve landmarks and to compare AR guidance with fluoroscopic guidance of TAVI deployment in an aortic root model. Methods Magnetic tracking sensors were integrated into the TAVI catheter and TEE probe, allowing these tools to be displayed in an AR environment. Variability in identifying aortic valve commissures and cuspal nadirs was assessed using TEE aortic root images. To compare AR guidance of TAVI deployment with fluoroscopic guidance, a TAVI stent was deployed 10 times in the aortic root model using each of the two guidance systems. Results Commissures and nadirs were both investigated as features for defining the valve annulus in the AR guidance system. The commissures were identified more consistently than the nadirs, with intraobserver variability of 2.2 and 3.8 mm, respectively, and interobserver variability of 3.3 and 4.7 mm, respectively. The precision of TAVI deployment using fluoroscopic guidance was 3.4 mm, whereas the precision of AR guidance was 2.9 mm, and its overall accuracy was 3.4 mm. This indicates that both have similar performance. Conclusions Aortic valve commissures can be identified more reliably than cuspal nadirs from TEE. The AR guidance system achieved similar deployment accuracy to that of fluoroscopy while eliminating the use and consequences of nephrotoxic contrast and radiation.

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Augmented Reality Image Guidance Improves Navigation for Beating Heart Mitral Valve Repair

Cited by 27 publications

References 23 publications

Systematic review on the effectiveness of augmented reality applications in medical training

Systematic review on the effectiveness of augmented reality applications in medical training

Cadaveric Simulation Training in Cardiothoracic Surgery: A Systematic Review

Augmented Reality System for Ultrasound Guidance of Transcatheter Aortic Valve Implantation

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