中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

虚拟现实技术在冠状动脉瘘和冠状动脉异常起源外科诊疗中的应用价值

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目的 评估虚拟现实技术在冠状动脉瘘(coronary artery fistula,CAF)和冠状动脉异常起源(abnormal origin of coronary arteries,AOOCA)的外科诊疗过程中的应用价值。 方法 2014 年 1 月至 2018 年 6 月期间,我院心外科应用虚拟现实技术辅助进行治疗方式决策和手术方案制定,对 4 例 CAF 与 4 例 AOOCA 患者实施外科治疗。CAF 患者中,男 1 例、女 3 例,年龄分别是 8 岁、16 岁、62 岁和 65 岁,AOOCA 患者中,男 1 例、女 3 例,年龄分别是 4 个月、2 岁、14 岁和 29 岁。 结果 8 例患者虚拟心脏模型与真实心脏匹配程度好,虚拟现实技术在所有患者中都能把解剖畸形部位及其周围的空间结构信息直观全面地展示出来。4 例 CAF 患者全部经冠状动脉切口进行修补,其中 2 例为自体心包补片修补,另外 2 例为直接缝补;4 例 AOOCA 患者中,3 例行冠状动脉直接移植术,1 例行 Takeuchi 术式,2 例同期行二尖瓣成形术。手术全部顺利完成,恢复良好,无严重并发症出现。4 例 CAF 患者中,3 例无残余瘘,1 例有微量残余瘘;4 例 AOOCA 患者冠状动脉均通畅,其中 2 例术前中-重度二尖瓣反流的患者术后反流明显减轻。 结论 虚拟现实技术可以让医生在术前更清晰地了解冠状动脉瘘或起源异常解剖畸形部位及其周围的空间结构信息,辅助医生在术前做出准确的治疗决策和制定详细的手术方案,保证手术安全性,有显著的临床应用价值。

Objective To evaluate the application value of virtual reality (VR) technology in the surgical treatment of coronary artery fistula (CAF) and abnormal origin of coronary artery (AOOCA). Methods From January 2014 to June 2018, with the assistance of virtual reality technology, 4 patients with CAF and 4 patients with AOOCA in the Department of Cardiac Surgery of our hospital underwent treatment method deciding and operation details planning. In the CAF patients, there was 1 male and 3 females and they were 8 years, 16 years, 62 years, and 65 years, respectively. In the AOOCA patients, there was 1 male and 3 females at age of 4-month, 2 years, 14 years, and 29 years, respectively. Results The virtual heart models in all 8 patients were well matched with the real heart. The spatial structure information of CAF/AOOCA and surroundings can be intuitively and fully shown by virtual reality technology in all patients. All of the 4 CAF patients repaired coronary artery incision, including 2 patients with autologous pericardium patch and 2 patients with direct suture. Of the 4 AOOCA patients, 3 underwent coronary directly transplantation but 1 underwent Takeuchi surgery. And 2 had mitral valve plasty at the same time. All the operations were completed successfully, with good recovery and no serious complications. Among the 4 CAF patients, 3 had no residual fistula, and 1 had minor residual fistula. Coronary arteries were all unobstructed in 4 patients of AOOCA; moderate and severe mitral regurgitation in 2 patients were significantly reduced after surgery. Conclusion VR allows doctors to understand the spatial structure information of CAF/AOOCA and surroundings before the operation, and assists them to make accurate treatment decisions and develop detailed surgical plans before the operation, ensuring its safety. Its clinical application value is significant.

关键词: 虚拟现实技术; 冠状动脉瘘; 冠状动脉异常起源

Key words: Virtual reality technology; coronary artery fistula; abnormal origin of coronary artery

引用本文: 邱海龙, 庄建, 岑坚正, 黄美萍, 高强, 陈寄梅, 温树生, 许刚, 崔虎军, 蔡晓维. 虚拟现实技术在冠状动脉瘘和冠状动脉异常起源外科诊疗中的应用价值. 中国胸心血管外科临床杂志, 2019, 26(3): 217-221. doi: 10.7507/1007-4848.201811041 复制

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