Utility of virtual reality imaging to guide complex structural cardiac interventions: A randomized controlled trial

Area of Science:

• Cardiovascular Interventions
• Medical Imaging
• Virtual Reality Applications

Background:

• Accurate preprocedural planning is essential for complex transcatheter structural heart interventions.
• Virtual reality (VR) imaging may enhance accuracy over conventional computed tomography (CT) and reduce operator variability.

Purpose of the Study:

• To evaluate the utility of VR in preprocedural planning for complex structural heart interventions.
• To compare the accuracy of VR-enhanced planning versus CT alone for operators with different experience levels.

Main Methods:

• A randomized study compared CT alone versus CT plus VR for preprocedural planning in 40 patients undergoing sinus venosus defect (SVD) closure, pulmonary artery (PA) stenting, or percutaneous pulmonary valve implantation (PPVI).
• Planning deviation during intervention was analyzed, comparing a senior cardiologist's CT-based plan with a junior cardiologist's plan using CT alone and CT plus VR.

Main Results:

• VR significantly reduced plan deviations for junior cardiologists, making their plans comparable to those of senior cardiologists.
• For sinus venosus defect closure, VR planning showed better agreement with procedural outcomes than senior cardiologist CT-only planning.
• No significant differences in planning accuracy were found for pulmonary artery stenting or percutaneous pulmonary valve implantation.

Conclusions:

• VR interpretation by junior cardiologists matched senior cardiologist CT-only plans and outperformed junior cardiologist CT-only plans.
• VR has the potential to accelerate training for structural interventions and standardize preprocedural planning.