New technology to aid surgeons with keyhole heart valve surgery

It will prevent converting a keyhole heart valve operation to open-heart surgery.

Using AI, augmented reality (AR), and virtual reality (VR), scientists at UWE Bristol’s Big Data lab and Faculty of Health and Applied Sciences (HAS) are developing a new technology to assist cardiac surgeons in planning and preparing for complex keyhole heart valve surgery. It will prevent converting a keyhole heart valve operation to open-heart surgery.

The team is initially collaborating with the Bristol Heart Institute (BHI), a Specialist Research Institute at the University of Bristol, whose surgeons will test the system when preparing for minimally invasive cardiac valve surgery (MICVS).

Conventional open-heart surgery requires cutting through the breastbone to reach the heart, which is quite invasive. Unlike conventional surgery, MICVS is less intrusive. It involves accessing the heart through smaller incisions using endoscopic instruments.

However, MICVS is complex and requires hours of pre-operative planning and preparation.

Dr. Hunaid Vohra, Consultant Cardiac Surgeon and Honorary Senior Lecturer and Researcher at the BHI, who is collaborating with UWE Bristol, said: “In the operating room, despite pre-planning, it is currently very common to find unexpected challenges, as every patient’s height, weight, and heart-lung anatomy is different. And patients’ frailty varies.

“Mixed Reality and AI will enhance our ability to prevent the conversion of a keyhole heart valve operation to an open heart surgery, avoiding two sets of scars, and delay in recovery.”

Scientists could tap into the patient’s medical data through this new technology. This will help them predict the risks associated with the procedure. The likelihood of adverse events is then presented to the surgeon on a HoloLens using AR.

Next, the surgeon will have access to AR technology to show a patient a 3D version of their heart and explain the procedure to them via headsets.

Dr. Muhammad Bilal, Associate Professor of Big Data and Artificial Intelligence at UWE Bristol and leading the research team, said: “Most terms surgeons use to describe heart surgery during consultation draw a blank from patients, and this system makes the explanation task much clearer and easier.” 

The VR feature of the technology will allow surgeons to access a complete digital version of the patient. They could perform the entire operation beforehand on a patient’s thoracic cavity replica.

Finally, in collaboration with UWE Bristol’s Centre for Print Research, surgeons performing very complex cases will be allowed to order a bespoke 3D printed model of the patient’s thoracic cavity mimicking organs, veins, and blood flow to simulate the procedure on a synthetic body.

Dr. Hunaid Vohra, Consultant Cardiac Surgeon, and Honorary Senior Lecturer and Researcher at the BHI, said, “This will enable us to practice before the actual operation and minimize the potential for things to go wrong on the day. Overall, we are excited to be involved in this technology, which could spell the future for highly successful minimally invasive procedures of this type in adults and babies.”

Dr. Bilal said, “Currently, the practice of MICVS is limited to a small group of surgeons in the world. This technology-enabled guidance promises to increase the number of doctors able to perform these operations, providing wider access to the general population.”

“There are significant engineering challenges to be resolved before this technology can be rolled out into the NHS, but our collaboration with the BHI provides a perfect testing ground.”

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