Fast‐track virtual reality for cardiac imaging in congenital heart disease

2021 ◽  
Author(s):  
Francesca Raimondi ◽  
Vladimiro Vida ◽  
Charlotte Godard ◽  
Francesco Bertelli ◽  
Elena Reffo ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Cardiac Imaging ◽  
Congenital Heart ◽  
Fast Track

scholarly journals P1417 Acceptability of a virtual reality system for examination of congenital heart disease patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Wheeler ◽  
S Deng ◽  
K Pushparajah ◽  
J A Schnabel ◽  
J M Simpson ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Decision Making ◽  
Training Session ◽  
Image Data ◽  
Clinical Decision ◽  
Anatomical Landmarks ◽  
Brief Training

Abstract Funding Acknowledgements Work supported by the NIHR i4i funded 3D Heart project [II-LA-0716-20001] Background/Introduction Virtual Reality (VR) has recently gained great interest for examining 3D images from congenital heart disease (CHD) patients. Currently, 3D printed models of the heart may be used for particularly complex cases. These have been found to be intuitive and to positively impact clinical decision-making. Although positively received, such printed models must be segmented from the image data, generally only CT/MR may be used, the prints are static, and models do not allow for cropping / slicing or easy manipulation. Our VR system is designed to address these issues, as well as providing a simple interface compared to standard software. Building such a VR system, one with intuitive interaction which is clinically useful, requires studying user acceptance and requirements. Purpose: We evaluate the usability of our VR system can a prototype VR system be easily learned and used by clinicians unfamiliar with VR. Method We tested a VR system which can display 3D echo images and enables the user to interact with them, for instance by translating, rotating and cropping. Our system is tested on a transoesophageal echocardiogram from a patient with aortic valve disease. 13 clinicians evaluated the system including 5 imaging cardiologists, 5 physiologists, 2 surgeons and an interventionist, with their clinical experience ranging from trainee to more than 5 years’ of experience. None had used VR regularly in the past. After a brief training session, they were asked to place three anatomical landmarks and identify a particular cardiac view. They then completed a questionnaire on system ease of learning and image manipulation. Results: Results are shown in the figure below. Learning to use the system was perceived as easy for all but one participant, who rated it as ‘Somewhat difficult’. However, once trained, all users found the system easy to use. Participants found the interaction, where objects in the scene are picked up using the controller and then track the controller’s motion in a 1:1 way, to be particularly easy to learn and use. Conclusion Our VR system was accepted by the vast majority of clinicians, both for ease of learning and use. Intuitiveness and the ability to interact with images in a natural way were highlighted as most useful - suggesting that such a system could become accepted for routine clinical use in the future. Abstract P1417 Figure. VR system evaluation participant feedbac

scholarly journals A Virtual Reality System for Improved Image-based Planning of Complex Cardiac Procedures

2021 ◽  
Author(s):  
Shujie Deng ◽  
Gavin Wheeler ◽  
Nicolas Toussaint ◽  
Lindsay Munroe ◽  
Suryava Bhattacharya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Patient Specific ◽  
Two Dimensional ◽  
Virtual Reality System ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

The intricate nature of congenital heart disease requires understanding of complex, patient-specific three-dimensional dynamic anatomy of the heart, from imaging data such as three-dimensional echocardiography for successful outcomes from surgical and interventional procedures. Conventional clinical systems use flat screens and therefore display remains two-dimensional, which undermines the full understanding of the three-dimensional dynamic data. Additionally, control of three-dimensional visualisation with two-dimensional tools is often difficult, so used only by imaging specialists. In this paper we describe a virtual reality system for immersive surgery planning using dynamic three-dimensional echocardiography, which enables fast prototyping for visualisation such as volume rendering, multi-planar reformatting, flow visualisation, and advanced interaction such as three-dimensional cropping, windowing, measurement, haptic feedback, automatic image orientation, and multi-user interactions. The available features were evaluated by imaging and non-imaging clinicians, showing that the virtual reality system can help improve understanding and communication of the three-dimensional echocardiography imaging and potentially benefit congenital heart disease treatment.

scholarly journals Fast-Track Extubation in Pediatric Cardiothoracic Surgery in Developing Countries

2017 ◽  
Vol 01 (01) ◽  
pp. 021-023 ◽  
Author(s):  
Federica Iezzi ◽  
Michele di Summa ◽  
Paolo Del Sarto ◽  
James Munene
Keyword(s):  
Developing Countries ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fast Track ◽  
Low Dose ◽  
Ventilatory Support ◽  
High Dose ◽  
Early Extubation ◽  
Anesthetic Agents

Objective In recent years, low-dose, short-acting anesthetic agents, which replaced the former high-dose opioid regimens, offer a faster postoperative recovery and decrease the need for mechanical ventilatory support. In this study, the aim was to determine the success rate of fast-track approach in surgical procedures for congenital heart disease. Methods There is some evidence, mostly from retrospective analyses, that fast tracking can be beneficial. Ninety-one cases with moderate complex cardiac malformations were operated with fast-track protocol during cardiothoracic charitable missions. The essential aspects of early extubation in our cohort included selected patients with good preoperative status, good surgical result with hemodynamic stability in low dose of inotropic drugs at the end of bypass, and no active bleeding. In this setting, a careful choice and dosing of anesthetic agents, alongside a good postoperative analgesia are mandatory. Results The authors found that an early extubation (< 4 hours) can be both effective and safe as it reduces intubation and ventilator times without increasing postoperative complications in pediatric congenital heart disease. Conclusion This study supports a wider use of fast-track extubation protocols in pediatric patients submitted for congenital cardiac surgery in developing countries.

scholarly journals Investigating the Feasibility of Virtual Reality (VR) for Teaching Cardiac Morphology

Electronics ◽  
2021 ◽  
Vol 10 (16) ◽  
pp. 1889
Author(s):  
Endrit Pajaziti ◽  
Silvia Schievano ◽  
Emilie Sauvage ◽  
Andrew Cook ◽  
Claudio Capelli
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ease Of Use ◽  
Patient Specific ◽  
Visual Aids ◽  
Diverse Range ◽  
Cardiac Morphology ◽  
General Response

Congenital heart disease (CHD) is the most common defect at birth. Effective training for clinical professionals is essential in order to provide a high standard of care for patients. Visual aids for teaching complex CHD have remained mostly unchanged in recent years, with traditional methods such as diagrams and specimens still essential for delivering educational content. Diagrams and other 2D visualisations for teaching are in most cases artistic illustrations with no direct relation to true, 3D medical data. Specimens are rare, difficult for students to access and are limited to specific institutions. Digital, patient-specific models could potentially address these problems within educational programmes. Virtual Reality (VR) can facilitate the access to digital models and enhance the educational experience. In this study, we recorded and analysed the sentiment of clinical professionals towards VR when learning about CHD. A VR application (VheaRts) containing a set of patient-specific models was developed in-house. The application was incorporated into a specialised cardiac morphology course to assess the feasibility of integrating such a tool, and to measure levels of acceptance. Attendees were clinical professionals from a diverse range of specialities. VR allowed users to interact with six different patient-derived models immersed within a 3D space. Feedback was recorded for 58 participants. The general response towards the use of VR was overwhelmingly positive, with 88% of attendees rating 4 or 5 for ‘helpfulness of VR in learning CHD’ (5-points Likert scale). Additionally, 70% of participants with no prior VR experience rated 4 or 5 for ‘intuitiveness and ease of use’. Our study indicates that VR has a high level of acceptance amongst clinical trainees when used as an effective aid for learning congenital heart disease. Additionally, we noted three specific use-cases where VR offered novel teaching experiences not possible with conventional methods.

scholarly journals A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development and Usability Testing (Preprint)

2020 ◽  
Author(s):  
Byeol Kim ◽  
Yue-Hin Loke ◽  
Paige Mass ◽  
Matthew R Irwin ◽  
Conrad Capeland ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Congenital Heart ◽  
Medical Images ◽  
Display System ◽  
Group Discussions ◽  
Medical Trainees ◽  
Display Systems

BACKGROUND The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied. OBJECTIVE The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD. METHODS A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions. RESULTS Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ<sup>2</sup><sub>2</sub>=9.0, <i>P</i>=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ<sup>2</sup><sub>2</sub>=14.1, <i>P</i>&lt;.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (<i>t</i>=–1.01, <i>P</i>=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants. CONCLUSIONS The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.

Use of advanced cardiac imaging in congenital heart disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jeremy M. Steele ◽  
Ryan A. Moore ◽  
Sean M. Lang
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Imaging ◽  
Congenital Heart

Cardiac Examination, Valvular Heart Disease, and Congenital Heart Disease

2012 ◽  
Author(s):  
Kyle W. Llarich
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Physical Examination ◽  
Cardiac Imaging ◽  
Congenital Heart ◽  
Imaging Techniques ◽  
Venous Pressure ◽  
Cost Effective ◽  
Cardiac Imaging Techniques ◽  
Positron Emission

Despite tremendous technologic advances in medical testing and imaging, physicians must be able to assess patients accurately at the bedside; this assessment allows appropriate, cost-effective, and efficient ordering of tests. Part I of this chapter outlines the salient features of a thorough physical examination, cardiac imaging techniques, and valvular and congenital heart disease. A thorough physical examination includes assessment of jugular venous pressure, arterial pulses, apical impulses, additional cardiac palpitations, and appropriate imaging techniques. Cardiac imaging techniques include contrast angiography, echocardiography, radionuclide imaging, magnetic resonance imaging, electron beam computed tomography and positron emission tomography. Different types of valvular and congenital heart disease are examined.

Sign in / Sign up

Export Citation Format

Share Document