OBJECTIVE: Stereoscopic vision display technology has been shown to be a useful tool in image-guided surgical interventions. However, the concept has not been applied to 3-dimensional echocardiography-guided cardiac procedures. We evaluated stereoscopic vision display as an aid for intracardiac navigation during 3-dimensional echocardiography-guided beating-heart surgery in a model of atrial septal defect closure. METHODS: An atrial septal defect (6 mm) was created in 6 pigs using 3-dimensional echocardiography guidance. The defect was then closed using a catheter-based patch delivery system, and the patch was attached with tissue mini-anchors. Stereoscopic vision was generated with a high-performance volume renderer with stereoscopic glasses. Three-dimensional echocardiography with stereoscopic vision display was compared with 3-dimensional echocardiography with standard display for guidance of surgical repair. Task performance measures for each anchor placement (N = 32 per group) were completion time, trajectory of the tip of the anchor deployment device, and accuracy of the anchor placement. RESULTS: The mean time of the anchor deployment for stereoscopic vision display group was shorter by 44% compared with the standard display group: 9.7 +/- 0.9 seconds versus 17.2 +/- 0.9 seconds (P < .001). Trajectory tracking of the anchor deployment device tip demonstrated greater navigational accuracy measured by trajectory deviation: 3.8 +/- 0.7 mm versus 6.1 +/- 0.3 mm, 38% improvement (P < .01). Accuracy of anchor placement was not significantly different: 2.3 +/- 0.3 mm for the stereoscopic vision display group versus 2.3 +/- 0.3 mm for the standard display group. CONCLUSION: Stereoscopic vision display combined with 3-dimensional echocardiography improved the visualization of 3-dimensional echocardiography ultrasound images, decreased the time required for surgical task completion, and increased the precision of instrument navigation, potentially improving the safety of beating-heart intracardiac surgical interventions.
OBJECTIVE: Stereoscopic vision display technology has been shown to be a useful tool in image-guided surgical interventions. However, the concept has not been applied to 3-dimensional echocardiography-guided cardiac procedures. We evaluated stereoscopic vision display as an aid for intracardiac navigation during 3-dimensional echocardiography-guided beating-heart surgery in a model of atrial septal defect closure. METHODS: An atrial septal defect (6 mm) was created in 6 pigs using 3-dimensional echocardiography guidance. The defect was then closed using a catheter-based patch delivery system, and the patch was attached with tissue mini-anchors. Stereoscopic vision was generated with a high-performance volume renderer with stereoscopic glasses. Three-dimensional echocardiography with stereoscopic vision display was compared with 3-dimensional echocardiography with standard display for guidance of surgical repair. Task performance measures for each anchor placement (N = 32 per group) were completion time, trajectory of the tip of the anchor deployment device, and accuracy of the anchor placement. RESULTS: The mean time of the anchor deployment for stereoscopic vision display group was shorter by 44% compared with the standard display group: 9.7 +/- 0.9 seconds versus 17.2 +/- 0.9 seconds (P < .001). Trajectory tracking of the anchor deployment device tip demonstrated greater navigational accuracy measured by trajectory deviation: 3.8 +/- 0.7 mm versus 6.1 +/- 0.3 mm, 38% improvement (P < .01). Accuracy of anchor placement was not significantly different: 2.3 +/- 0.3 mm for the stereoscopic vision display group versus 2.3 +/- 0.3 mm for the standard display group. CONCLUSION: Stereoscopic vision display combined with 3-dimensional echocardiography improved the visualization of 3-dimensional echocardiography ultrasound images, decreased the time required for surgical task completion, and increased the precision of instrument navigation, potentially improving the safety of beating-heart intracardiac surgical interventions.