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Real-time intraoperative visualization of myocardial circulation by augmented reality temperature display
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology.
Thermirage AB, Linköping, Sweden.
Thermirage AB, Linköping, Sweden.
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2010 (English)In: Minimally invasive therapy and allied technologies, Informa Healthcare, 2010, 61-61 p.Conference paper, Abstract (Other academic)
Abstract [en]

Background:  Intraoperative  ischemia   during   coronary   surgery   may   have   severe   consequences   for the patient and may also pose a difficult diagnostic problem  to the  surgeon.  There  is no  clinically used direct  method  to evaluate  the  effect on  the  circulation of various therapeutic maneuvers  to the heart. Augmented (mixed)  reality using projection  of color- coded  infra-red  (IR)  images onto  the imaged  tissues in real  time  may  give an  intuitive  representation of the tissue surface temperature and thus,  information about   myocardial   perfusion   on  the  surface  of  the organ itself.

Purpose:  To demonstrate in animal experiments the feasibility of presenting  IR tissue temperature images  reflecting  myocardial  perfusion into  the  surgical  field  with  augmented reality.

Method: We  have  constructed a  system  consisting of an IR camera  and  a projector  integrated in such a way that  they  have  identical  optical  axes,  solving the  geometrical  correspondence problem  in an easy way. In 5 pigs (weight = 57.5 ± 7 kg), the thorax was opened    by   median    sternotomy.   After   exposing the  heart,  an  elastic  vessel loop  was placed  around the  middle  of  the  left  descending  coronary  artery. A  2  mm   ultrasound  probe   was  inserted   distally around the LAD for flow velocity measurements. Subsequent ischemia-reperfusion periods  were induced using a fixed protocol. 

Results:  The  time course of  an   occlusion   was  clearly  seen   in  quantitative curves  as well as in  color-coded temperature  maps on the surface of the heart.  The  difference in surface temperature between the three areas more or less affected  by  the  ischemia   was  also  clearly  demon- strated.  During  ischemia,  the surface of the myocardium  showed  concentrically  arranged  zones  of different temperatures (IR penumbra) potentially cor- responding to different  degrees  of severity of ischemia. 

Conclusion: Surface  temperature changes  due to ischemia can be assessed quantitatively and visualized  in situ during occlusion of a coronary  artery and   subsequent  reperfusion of  the myocardium. This method shows potential  as  a  fast  and  simple way of  following  myocardial  perfusion  during surgery. The  change  of the  extension  of the  penumbra zone  is a potential monitoring device  for the  thera- pies used  in the salvage or prevention of ischemia  in experimental or clinical cardiac surgery and may introduce new practices in monitoring  duringcardiac  and vascular anesthesia.

Place, publisher, year, edition, pages
Informa Healthcare, 2010. 61-61 p.
, Minimally Invasive Therapy, ISSN 1364-5706 ; 19 Suppl 1
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-93659DOI: 10.3109/13645706.2010.500867OAI: diva2:625579
22nd International Conference of the Society for Medical Innovation and Technology (SMIT), 2-4 September 2010, Trondheim, Norway
Available from: 2013-06-05 Created: 2013-06-05 Last updated: 2014-03-06Bibliographically approved

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Szabó, ZoltánSjökvist, StefanWren, JoakimBerg, SörenAhn, HenrikSmedby, Örjan
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Thoracic SurgeryFaculty of Health SciencesDepartment of Thoracic and Vascular SurgeryApplied Thermodynamics and Fluid MechanicsThe Institute of TechnologyRadiologyDepartment of Radiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)
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