Image Guidance Techniques for Minimally-Invasive Off-Pump Intracardiac Interventions

RESEARCH INTERESTS

The development, testing, validation and clinical integration of:

• Minimally Invasive Surgical Systems
• Computer-Aided Diagnostic Tools
• Image-guided Techniques for Surgery and Therapy

In spite of the recent technological advancements, most heart surgeries still involve the use of the heart-lung machine, manipulation of the aorta, and preservation of the heart before the surgeon even enters the heart. In an effort to reduce these complications, we aim to develop new methods to perform these surgeries on the beating-heart. Surgeons will be able to safely reach inside the beating heart, eventually eliminating the need of the heart-lung machine and all of its undesirable consequences.

Since the surgeon will no longer be able to directly look inside the heart while it is beating, we will replace the traditional view of the surgical field with a so-called “virtual reality space” (fake space), which accurately resembles the “real surgical space” – the heart chambers, structures of interest, and surgical tools. This fake space consists of images of the heart gathered both before and during the operation, as well as models of the instruments used in surgery. As such, the surgeon will have access to: a global 3D view of the heart from images taken prior to surgery (i.e. entire map of a city); a detailed view of the specific location where the therapy is delivered from images taken during surgery (i.e. a “zoom-in” of the region of interest); and the location of the surgical tools the surgeon manipulates (i.e. ones location on the map with respect to the point of interest) (that sentence was a little tough).

The final product consists of a complete environment that provides the surgeon with all the necessary information to “see”, navigate tools, and deliver therapy within the human body.

 

KEY QUESTIONS

• Can an augmented virtual reality environment replace surgeon’s eyes and provide them with sufficient visualization and guidance information required to deliver therapy to targets located inside the beating heart in absence of direct vision?
• Can pre-operatively acquired 3D and 4D medical images be used to build subject-specific anatomical models that can be integrated within the virtual surgical environment to augment intra-operative real-time ultrasound imaging?
• How accurately should these models be to provide sufficient anatomical context to enhance intra-procedure planning and navigation of off-pump cardiac interventions?
• What are the limitations with respect to the translation of such minimally invasive image guidance therapy techniques into the clinical environment and
• What is the range of the clinical applications targeted by these novel approaches?

 

SELECTED PUBLICATIONS

Peer Reviewed Papers

1. Linte CA, Moore J, Wiles, AD, Wedlake, C. and Peters TM. Virtual Reality-Enhanced Ultrasound Guidance: A Novel Technique for Intracardiac Interventions. Journal of Computer Aided Surgery. Vol. 13(2). pp. TBD. (In Press: 2008).

2. Linte CA, Wierzbicki M, Peters TM and Samani A. Towards a Biomechanics-Based Technique for Assessing Myocardial Contractility: An Inverse Problem Approach.Comput Methods in Biomech Biomed Engin. Vol. 11 (2), pp. TBD, 2008.

3. Linte CA, Wierzbicki M, Moore JT, Guiraudon GM, Little SH, and Peters TM. Towards Subject-Specific Models of the Dynamic Heart for Image-Guided Mitral Valve Surgery. Medical Image Computing and Computer-Assisted Interventions – MICCAI 2007: 10th International Conference, Brisbane, Australia. Oct. 29 - Nov. 2, 2007. Lecture Notes in Computer Science, Vol. 4792. Part II. N. Ayache, S. Ourselin and A. Maeder (Eds). pp. 94-101, 2007.

4. Linte CA, Wierzbicki M, Moore JT, Guiraudon GM, Jones DL and Peters TM. On Enhancing Planning and Navigation of Beating-Heart Mitral Valve Surgery Using Pre-operative Cardiac Models. IEEE Engineering in Medicine and Biology Society – EMBS: 29th International Annual Conference, Lyon, France. Aug. 23 - 26, 2007. Proc IEEE Eng Med Biol Soc. pp. 475-478. 2007

5. Linte CA, Wiles AD, Moore JT, Wedlake C, Guiraudon GM, Jones DL, Bainbridge D and Peters TM. An Augmented Reality Environment for Image-Guidance of Off-Pump Mitral Valve Implantations. International Symposium on Medical Imaging 2007. San Diego, CA, USA. Feb. 17 - 22, 2007. Proc of SPIE 6509: Visualization and Image-Guided Procedures. K Cleary and M Miga (Eds). pp. 6509ON-12. 2007 (Second Place – Michael B. Merickel Best Student paper Award).

CURRICULUM VITAE

CV (download PDF)