First Experience With Augmented Reality Guidance for Cerebral Embolic Protection During TAVR

Area of Science:

• Medical Technology
• Interventional Cardiology
• Surgical Navigation

Background:

• Augmented reality (AR) offers potential for improved transcatheter interventions through 3D virtual content visualization.
• Cerebral embolic protection (CEP) device placement during transcatheter aortic valve replacement (TAVR) increases radiation, contrast use, and procedure time.
• AR may enhance procedural guidance for safer TAVR interventions.

Purpose of the Study:

• To develop and test a novel AR guidance system for TAVR.
• To assess the intraprocedural impact of AR during CEP placement in TAVR.
• To evaluate AR's effect on contrast volume, procedure time, and physician experience.

Main Methods:

• Prospective enrollment of TAVR patients undergoing CEP into AR guidance or control groups.
• Primary endpoints: contrast volume, time to filter placement, fluoroscopy time.
• Postprocedure questionnaires assessed physician experience with AR guidance.

Main Results:

• AR guidance eliminated the need for pre-device aortic arch angiograms, reducing contrast volume (0 mL vs 15 mL, P < 0.0001).
• No significant differences observed in filter placement time or fluoroscopy duration.
• AR guidance increased physician confidence in aortic arch wiring and facilitated device placement.

Conclusions:

• A novel AR system was developed for TAVR CEP placement.
• The AR system eliminated the need for additional angiograms, reducing contrast volume.
• AR guidance improved procedural performance without increasing intervention time.