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Computer Assisted Surgery Prenatal Cardiac Intervention

计算机辅助手术产前心脏干预

基本信息

批准号：
6790742
负责人：
CONSTANTINOS NIKOU
金额：
$ 9.94万
依托单位：
CASURGICA, INC.
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-03-01 至 2004-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6790742
关键词：
aortic valve stenosis bioengineering /biomedical engineering bioimaging /biomedical imaging biomedical equipment development cardiovascular imaging /visualization cardiovascular surgery computer assisted patient care congenital heart disorder embryo /fetus surgery heart catheterization heart ventricle technology /technique development three dimensional imaging /topography ultrasonography

项目摘要

DESCRIPTION (provided by applicant): Approximately 1% of babies born require operative treatment for congenital heart diseases. Worldwide, 80,000 pediatric cardiac procedures are performed annually. These procedures are all performed postnatally. However, based on a growing recognition that earlier anatomic repair is beneficial to the health of the child, it has become clear that prenatal cardiac intervention (PCI), though revolutionary, is highly desirable to correct aortic valve stenoses and other abnormalities that lead to hypoplastic left heart syndrome (HLHS). At the same time the technology available for PCI is clearly deficient. Ours is a proposal to begin a multi-phase effort to realize technologies and interventional techniques that will make it possible to perform extraordinarily delicate and intricate cardiac procedures on a fetus while it is in the mother's womb, i.e., using minimally invasive in utero techniques. The overall concept is to provide the interventionalist graphical displays, navigation aids and in vivo sensing capabilities that enable a PCI and confirm its efficacy. The essence of our approach is to make minor augmentations of the equipment and devices currently used for PCI, but in so doing to make a significant increase in the information content provided to the interventionalist. The specific research proposed here is to develop an optical position tracking solution for instruments used in PCI that will enable their relative locations to be measured with high accuracy and in real time. Based on those data, a graphical display that combines ultrasound imagery and navigation data will readily created. With this real time display, the interventionalist will have the means to visualize the exact location of catheters and introducers even if they not clearly evident in the ultrasound images. Further, the display will show other salient geometric features, such as the trajectory a catheter will follow if it is inserted further and distances and angles between that tool path and the ultrasound image. The prototype system will be based on three technologies we have developed for orthopaedic surgery. This research will be conducted in partnership with Carnegie Mellon University's Robotics Institute and the Cardiology Department of Children's Hospital of Pittsburgh. In Phase Two, we will conduct in vivo tests of the sensors in appropriate animal models.

描述（由申请人提供）：大约1%的婴儿出生需要手术治疗先天性心脏病。全世界每年进行80，000例儿科心脏手术。这些手术都是在产后进行的。然而，越来越多的人认识到，早期的解剖修复有利于儿童的健康，很明显，产前心脏介入治疗（PCI），虽然革命性的，是非常可取的，以纠正主动脉瓣狭窄和其他异常，导致发育不良的左心综合征（HLHS）。与此同时，可用于PCI的技术明显不足。我们的建议是开始一个多阶段的努力，以实现技术和介入技术，使之有可能执行非常微妙和复杂的心脏手术的胎儿，而它是在母亲的子宫，即，使用子宫内微创技术。总体概念是提供介入医生图形显示、导航辅助和体内感知功能，以实现PCI并确认其有效性。我们的方法的本质是对目前用于PCI的设备和装置进行微小的增强，但这样做是为了显著增加提供给介入医生的信息内容。这里提出的具体研究是为PCI中使用的仪器开发一种光学位置跟踪解决方案，使其相对位置能够以高精度和真实的时间进行测量。基于这些数据，结合超声成像和导航数据的图形显示将很容易创建。通过这种真实的时间显示，介入医生将有办法可视化导管和导引器的确切位置，即使它们在超声图像中不清楚。此外，显示器将示出其他显著的几何特征，诸如如果导管进一步插入则导管将遵循的轨迹以及该工具路径与超声图像之间的距离和角度。原型系统将基于我们为骨科手术开发的三种技术。这项研究将与卡内基梅隆大学机器人研究所和匹兹堡儿童医院心脏病科合作进行。在第二阶段，我们将在适当的动物模型中进行传感器的体内测试。