Computer-based Quantification of Reconstructive Mitral Valve Surgery

• Applicants: Professor Raffaele De Simone, Ph.D.; Professorin Dr. Sandy Engelhardt
• Subject Area: Cardiac and Vascular Surgery ; Epidemiology and Medical Biometry/Statistics
• Term: from 2018 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 398787259

Reconstructive heart valve surgery is a challenging form of surgical therapy with regard to valve insufficiency. Especially reconstructions of the mitral valve are associated with a high complexity, which arise from pathological diversity and various existing surgical strategies. To date, alternative less complicated surgical approaches such as mitral valve replacements are still conducted far too frequently in clinical routine, despite the fact that long term intake of anticoagulants are harming patient’s life quality after the surgical intervention. The aim of the project is to capture the surgical approach during mitral valve reconstruction and the disease pattern of the patient in a detailed and novel quantitative matter. This will be done in a close collaborative effort between medical informatics and cardiac surgery using computer-based methods that are developed within the scope of this project. Comprehensive quantifications enable a systematic and objective comparison of different surgical strategies and their precise conduction. Within the scope of the project, methods for video based stereoscopic endoscopy will be further developed to automatically determine and quantify the deformed intraoperative valve morphology. To the best of our knowledge, such techniques have not been applied to mitral valve surgery so far. This technique allows for an entirely new computer-assisted analysis of the surgical procedure. For example, precise geometrical corrections to the annulus by a prosthetic ring becomes retraceable. Furthermore, a comparative prospective clinical study of the novel computer-assisted approach in contrast to the traditional, analogous mitral valve analysis will be conducted. Within the scope of the holistic perioperative analysis, relationships between conventional parameters and image modalities such as echocardiography are established. Echocardiography captures pre- and postoperative functional morphology and is further used in this project for modelling of the dynamic mitral valve apparatus with existing segmentation tools. The project represents a significant step forward towards future research in the field of computer based analysis of soft tissue as well as prediction of the deformed intraoperative and remodelled postoperative valve geometry, which offers interesting future perspectives.

• DFG Programme: Research Grants
• Co-Investigators: Professor Dr. Matthias Karck; Professor Dr. Ivo Wolf