Key result
Virtual reality ViV-TAVI planning strongly correlates with standard software measurements and improves spatial understanding.
Why the study?
MSCT analysis, the gold standard for ViV-TAVI pre-procedural planning, has limitations that virtual reality delivering 3D patient-specific information might optimize.
Does virtual reality software provide accurate measurements and improve pre-procedural planning for valve-in-valve TAVI compared to standard MSCT analysis?
Observational (n=20)
Single-blind
Does virtual reality software provide accurate measurements and improve pre-procedural planning for valve-in-valve TAVI compared to standard MSCT analysis?
Virtual reality provides accurate, reproducible measurements and superior 3D visualization for pre-procedural planning of valve-in-valve TAVI compared to standard MSCT analysis.
Answers are grounded in this paper and cite their sources.
VR may aid ViV-TAVI planning; leaves open impact on procedural outcomes.
Aims Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has proven to be an effective treatment option for high-risk patients with degenerated surgical bioprosthetic aortic valves. Multislice computed tomography (MSCT) analysis, the current gold standard for procedural planning, has certain limitations. Virtual reality (VR) could optimize pre-procedural planning by delivering three-dimensional (3D) patient-specific information. This study aimed to investigate the feasibility of visualizing the bioprosthesis and adjacent structures with VR, as well as the accuracy and reproducibility of VR measurements and their advantages and limitations in planning ViV-TAVI. Methods and results The visualizations and measurements were performed using 3mensio software and VR software by analysts blinded to the results of the other software based on MSCT data from 20 patients who underwent ViV-TAVI interventions. Moreover, eight physicians graded numerous aspects of pre-procedural ViV-TAVI planning with and without VR visualizations. The analysis showed no significant differences between the measurements and strong correlations with correlation coefficients between 0.874 and 0.994, P < 0.001. Moreover, good-to-excellent intra- and interobserver reliability with intraclass correlation coefficient values between 0.897 and 0.986 was documented. The qualitative analysis showed that 3D visualization using VR facilitates assessing the spatial relationships between the structures. Furthermore, VR enabled a superior visual understanding of the bioprosthesis and the distances between the virtual prosthesis and the coronaries as well as the sinotubular junction. Conclusion Virtual reality can be a valuable addition to the pre-procedural planning of ViV-TAVI interventions, thanks to detailed 3D visualization and precise measurements. Further studies are needed to assess the impact on patient outcomes.
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Kanschik et al. (2025) conducted an observational in Degenerated surgical bioprosthetic aortic valves requiring ViV-TAVI (n=20). Virtual reality (VR) visualization vs. 3mensio software (standard MSCT analysis) was evaluated on Accuracy and reproducibility of measurements (correlation between VR and 3mensio software) (correlation coefficients 0.874 to 0.994, p=< 0.001). Virtual reality visualization for ViV-TAVI planning yielded measurements highly correlated with standard software and improved spatial understanding of adjacent structures.
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