Image guidance for coronary artery bypass grafting

Abstract

Objective

Open heart bypass graft surgery is the standard treatment for advanced cases of coronary heart disease. Optimal placement of the bypass graft anastomosis is very important for the success of the procedure. Therefore, detailed and precise knowledge about the path and morphology of the target vessel is crucial for the operating surgeon.

Materials and methods

To provide such information during the procedure, a novel surgical assistance system for open heart bypass graft surgery was designed which merges preoperative maps of the coronary arteries with intraoperative data. The patient-specific vessel map was generated from multi-slice computed tomography (MSCT), while the intraoperative data were obtained using a stereo camera system. A registration approach based on mutually shared anatomical landmarks on the heart surface was employed.

Results

Successful registration of MSCT and stereo video data was performed for five patients, demonstrating that 2D–2D and 3D–3D Procrustes registration could produce mean accuracies between 2 and 5 mm.

Conclusion

The target vessel visualization and registration approach presented in this work is feasible and can produce accuracies sufficient to justify future in vivo intraoperative testing.