Case Studies

Enhancing cardiac preoperative planning with the C-Station and Vesalius3D

PS-Medtech’s C-Station™ in combination with Vesalius3D™ software, removes the barrier between 2D images and 3D reconstruction. Dr. Sardari, cardiothoracic surgeon, owns one of the 12 C-Stations currently being used in the Maastricht University Medical Center(MUMC). “I have been using the C-Station for 3 years for evaluation of mitral and aortic valve surgeries in research setting. 3D reconstruction of patients’ anatomy is valuable within the preoperative planning process, and the C-Station provides surgeons with a fast surgical view of each patient. By having a clear surgical view of a patient, we can determine easier whether a patient is suitable anatomically for certain minimally invasive surgery (MIS) procedures”.

 

3D image of the left ventricle, mitral and aortic valve visualized in Vesalius3D
The C-Station provides surgeons with a fast and clear surgical view of each patient.
Dr. Sardari, cardiothoracic surgeon Maastricht University Medical Center

 

“The C-Station is helpful to see the anatomic variations of each patient. For instance, when planning an aortic valve surgery, knowing the exact position of the aortic root is helpful, as not all patients have the valve at the same position. The C-Station shows this information, which enables surgeons determining the ideal position to make the incision”.

 

Dr. Sardari uses the C-Station and Vesalius3D to train and show his findings to colleagues. In regard to the difficulty to get used to work with this innovative system, Dr. Sardari points out that “the C-Station is user friendly and intuitive. Learning how to use it is easy”.

 

Dr. Sardari working with the C-Station

Dr. Sardari working with the C-Station in his office in the MUMC

According to Dr. Sardari, the use of 3D CT scan reconstruction to determine whether a patient is suitable for MIS is a feasible method. Together with Dr. Heuts and Dr. Maessen, they published an article about this topic:

 

Heuts S, Maessen JG, Sardari Nia P. Preoperative planning of left-sided valve surgery with 3D computed tomography reconstruction models: sternotomy or minimally invasive approach? Interact CardioVasc Thorac Surg 2016; doi:10.1093/icvts/ivv408. Further research and studies will be conducted to proof the value of 3D reconstructions in clinical setting.

 

Link: http://www.ncbi.nlm.nih.gov/pubmed/26826714

 

 

Solving the problem of locating a perforation within the atria (LUMC, Leiden, The Netherlands)

It is as if you hold a patient’s heart in your hands. This is the way cardio specialist Eduard Holman of the LUMC hospital describes it when he works with the new 3D visualization of the hart. The result: unique images, that give more information than ever before.

Situation

To diagnose a patient with heart problems a (2D) ultrasound is made. The 2D ultrasound only shows a small part of the heart and you need to be a specialist to make the correct diagnosis

Complication

For example using 2D ultrasound to determine the exact location of a perforation between the atria is very difficult.

Solution

The C-Station shows the heart in 3D, showing the whole heart, which makes it easier to find the exact location of the perforation. By using these 3D volumetric images the cardiologist and surgeons have a better overview and as such are  better prepared to perform the surgery. The C-Station is used to facilitate patient discussions.

Cardiology: Traditional 2D diagnosis and the benefits of PS-Techs technology

Situation

We work on a daily basis in a multidisciplinary team, consisting of cardiologists and cardio-thoracic surgeons, to diagnose and treat complicated heart valvular diseases. To this end, adequate visualization of anatomy and pathology is mandatory to determine diagnosis, and formulate a surgical strategy. 2D echocardiography is up to now the cornerstone in this process.

Steven A.J. Chamuleau, MD, PhD
The benefits of PS-Medtechs technology is that the 3D workstations are the new stethoscopes of the cardiologist-of-the-future!
Steven A.J. Chamuleau, MD, PhD UMCU Medical Solution

Complication

Each individual specialist creates a virtual 3D image of the valve, based on the presented 2D images, in his own mind. However, there is no way to determine if all members of the team have identical views of the valve in mind which is essential for clinical decision making. Recently, 3D echocardiography has entered the clinical arena, but post processing these images on a 2D screen is laborious and sometimes even counter intuitive, and thus not a definite solution.

Implementation

In specific: the actual 3D images using PS-Techs technology allow all members of the team to actually see the valve. By using the free-hand plane, every desired cross section through the valve is easily obtained. Ultimately, quantification of severity (e.g. planimetry, volume rendering) might further improve the diagnostic accuracy of this modality.

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