Immersive 3D virtual reality (VEA) demonstrated excellent consistency with standard CT for annular (ICC=0.93) and LVOT (ICC=0.90) measurements, improving TAVI prosthesis size selection accuracy.
Does immersive 3D virtual reality (VEA) improve the accuracy of pre-procedural anatomical assessment and prosthesis sizing compared to standard CT analysis in TAVI candidates?
Immersive 3D virtual reality (VEA) provides reliable aortic root measurements and improves prosthesis size selection accuracy for TAVI planning compared to conventional CT.
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Abstract Background Accurate anatomical assessment is essential for pre-procedural planning in structural heart disease. Advanced 3D imaging could offer improved visualization for more accurate reconstruction. We assessed the performance of a novel immersive 3D virtual reality (VEA) for the pre-procedural planning of transcatheter aortic valve implantation (TAVI) candidates. Methods . Measurement of cardiac-gated contrast-enhanced computed tomography (CT) scans was performed with the novel VEA and established tools: 3Mensio and Horos. Results 50 consecutive patients were included. Annular and LVOT measurements obtained with VEA were strongly correlated with those derived from standard CT analysis. The intraclass correlation coefficient (ICC) confirmed excellent consistency for annular measurements (ICC=0.93), while the concordance correlation coefficient indicated very good overall agreement (CCC=0.83, 95%CI 0.73–0.90) (Figure, left panel). Similarly, LVOT measurements obtained with VEA showed strong correlation with CT values, with good consistency (ICC=0.90), and good overall agreement (CCC =0.77, 95% CI 0.64–0.86) (Figure, right panel). VEA–based planning improved prosthesis size selection accuracy, achieving higher concordance with implanted valves and a significant net reclassification gain over conventional CT. Conclusions Given the increasing use of advanced 3D cardiac imaging technologies, understanding their diagnostic accuracy to guide preprocedural planning of TAVI is paramount. In our study, VEA provided reliable assessment of aortic root anatomy for TAVI planning. This novel 3D software provides accurate, patient-specific reconstructions of the aortic root and surrounding structures, that may optimize valve sizing, improve procedural safety and enhance procedural outcomes. This provides a rational for future studies to assess the procedural benefit derived from a three-dimensional assessment of the aortic valve geometry.FigureFor image description, please refer to the figure legend and surrounding text.
Carabetta et al. (Sun,) reported a other. Immersive 3D virtual reality (VEA) demonstrated excellent consistency with standard CT for annular (ICC=0.93) and LVOT (ICC=0.90) measurements, improving TAVI prosthesis size selection accuracy.