JMIR Publications

ABSTRACT

Background:

Coronary artery bypass grafting (CABG) planning requires advanced spatial visualization and consideration of factors such as the depth of coronary arteries in the subepicardium, calcification, and pericardial adhesions.

Objective:

This study aimed to fulfill these needs by reconstructing a dynamic cardiovascular model, display it as a naked-eye hologram, and assess the feasibility of this novel visualization tool.

Methods:

Using preoperative 4-dimensional cardiac computed tomography angiography (4D-CCTA) data from 14 patients undergoing CABG, dynamic reconstructions of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries were created to reflect their spatial location, coronary stenosis and calcification, coronary depth in EAT, and pericardial adhesions. Dynamic cardiovascular holograms were generated and displayed on the Looking Glass® platform.13 cardiac surgeons retrospectively assessed the performance of the holographic visualization tool by using a Likert scale. A surgeon visually scored pericardial adhesions in the holograms of all 21 patients (including other 7 patients undergoing secondary cardiac surgery) and compared the scores with the actual intraoperative finding.

Results:

Thirteen cardiac surgeons rated the visualization tool highly due to its impressive display and good correlation with actual intraoperative situation. Meanwhile, the hologram-based pericardial adhesion score was correlated with the pericardial adhesion condition score at the operation (correlation coefficient: r = 0.786, P < 0.001).

Conclusions:

This study delineates the structural framework of a visualization tool designed for the preoperative planning of CABG procedures, generates high-quality, clinically relevant, dynamic holograms by employing genuine volumetric data from patients. The feedback from clinicians is very positive, verifying its feasibility in preoperative planning.