Takeo Tedoriya
Ageo Central General Hospital, Japan
Title: Virtual Reality Image Analysis in Aortic Valve Leaflet Reconstruction
Biography
Biography: Takeo Tedoriya
Abstract
Aortic valve reconstruction with three same-sized autologous pericardial leaflets has been performed for patients with narrow aortic roots or contraindication for valve-prostheses. Since this procedure requires precise information of the aortic root including configuration of Valsalva sinus, we assessed physiologic-anatomical condition of the aortic root by Virtual Reality (VR) Image in order to accomplish this technique with a reproducible fashion. VR Imaging; Enrolled patients underwent enhanced ECG-triggered cardiac CT. Axial images using a 264-row CT with slice thickness of 0.625mm were obtained during mid-to-end diastole. Subtracted volume rendering data of the aortic root were converted to stereolithography (STL) file in Visalius3D, a novel 3D workstation. Preoperatively the aortic root was assessed in order to decide neo-commissure and offsetting of deviated nadir in cases of unbalanced aortic root, like type 0 bicuspid valve. Basic surgical technique was; 1) same-sized three pieces of leaflets from autologous pericardium were tailored to original templates referred by STJ diameter, 2) the new commissures and nadirs were confirmed based on VR image (in case the non-coronary nadir deviated toward the left ventricle, a crescent form Valsalva plication were required), 3) three leaflets were sutured on the cusp-sutureline, 4) commissure coaptation stitches were placed between each leaflet to prevent from minor leakage and coronary orifices obstruction. Postoperative echocardiography revealed nicely opening of new-leaflet with no AR. VR image analysis had notably provides valuable information for understanding of precise anatomy of the aortic root.