Computer assisted transapical aortic valve implantation

Abstract

Aortic valve stenosis is the most frequent acquired valvular heart disease in the elderly. Transapical aortic valve implantation (TA-AVI) is a novel minimally invasive surgical technique that is applied to elderly patients with high operative risk. TA-AVI is performed via an anterolateral minithoracotomy using transcatheter techniques. Precise intraannular and subcoronary positioning of the valve is crucial, since major complications can arise from misplacement. We propose the introduction of computerized surgical assist systems into the TA-AVI workflow to aim at an optimized positioning and thus minimize the potential risks. A planning step is introduced at the beginning of the intervention. In order to support exact positioning of the prosthesis, an image based tracking system is proposed, which highlights the aortic valve prosthesis.