Virtual Reality in Cardiac Care Series: Planning Cardiac Procedures, Enhancing Education

This story is part one of our series on the ways virtual reality (VR) is transforming the world of cardiac care. In this article, you’ll learn how cardiologists at Children’s Health℠ use VR to plan and visualize procedures.

In part 2, we walk through how VR helped us plan for a challenging case—an infant with double outlet right ventricle (DORV). Read Rowan’s story.

Slip on a virtual reality headset (VR) at The Heart Center at Children’s Health, and you could find yourself standing inside a heart with double outlet right ventricle. With a wave of the controller, the heart spins around, allowing you to explore the congenital heart defect from every angle.

This kind of three-dimensional, immersive experience is at the forefront of medical innovation – and is quickly becoming an important tool for the cardiology team. Thanks to advanced software and imaging, physicians are now using VR to improve medical education, plan and visualize procedures and ultimately improve patient care.

“Every patient’s heart is subtly different. Our goal is to use VR to visualize each patient’s unique anatomy and develop the best plan for them. It’s truly individualized medicine,” says Animesh (Aashoo) Tandon, M.D., M.S., Pediatric Cardiologist at Children’s Health and Assistant Professor of Pediatrics at UT Southwestern who specializes in cardiac imaging and MRI.

Virtual Surgical Planning

Preprocedural planning is VR’s most useful application for our cardiac surgeons, especially for patients with complex conditions or particularly unique anatomies.

Dr. Tandon and the imaging team collaborate with our cardiothoracic surgeons and interventionists to create the best plan for each patient. What they see in the VR headset shapes which surgical technique they’ll use, how they’ll do it and what to watch out for.

“We walk through the anatomy together and talk about which approach is best,” Dr. Tandon says. “Even with common congenital heart defects, there are a lot of variations and minute differences between patients’ hearts. And, if it’s a complicated case, it’s even more important to know every detail of that patient’s anatomy.”

Visualizing Complex Cases

One of their more challenging cases was an infant named Rowan, who had double outlet right ventricle (DORV), a condition where the aorta and the pulmonary artery both come from the right ventricle. Surgery can be challenging because DORV presents in different anatomical configurations.

“Where are the holes and the outflows? It really matters how these things are related to each other and the ventricle because that changes our surgical approach,” Dr. Tandon says.

The team used VR to examine the patient’s heart from every angle and map out the optimal treatment plan.

“Getting to walk through Rowan’s heart prior to going to the operating room was probably one of the most exciting moments in my pediatric cardiothoracic surgical career; until this moment we’ve only had glimpses of what the three-dimensional relationships of important intracardiac structures by 3D echocardiography,” says Camille Hancock Friesen, M.D., who performed Rowan’s surgery. “This opens up a whole new world of preoperative planning. Now I’m asking Dr. Tandon and his colleagues to pre-print patches for me to create the best possible reconstructions.”

Sizing Cardiac Devices—Before Surgery

VR can also be used to plan ventricular assist device (VAD) placements. Surgeons can try out a few devices to find the best fit—before they open the patient’s chest. That’s especially helpful in pediatric patients with congenital heart defects, whose small size and challenging anatomy can make selecting and placing a VAD difficult.

“VADs are primarily made for adults, so it’s very helpful to be able to anticipate how well they will fit in a child,” Dr. Tandon says.

For example, our cardiology team recently saw a patient who needed support for both ventricles. During planning, they placed both devices in the patient’s virtual heart—and found that two pumps wouldn't fit next to each other. That discovery changed the surgeon’s approach in the operating room.

Improving Medical Education with VR

Ultimately, Dr. Tandon and the team hope VR can benefit not only individual patients, but also the larger medical community. They’re currently working on an initiative to digitize hundreds of individual patient models and create educational VR videos about common types of heart disease using untethered headsets.

Dr. Tandon believes VR could be a great supplement to cadaver dissection. “Many of these congenital heart defects are rare, and you may never see a cadaver with this specific defect,” he says. “By making these models of many different types of heart disease available, students can interact with them – in 3D – whenever they want.”

This is part 1 of our series on Virtual Reality in Cardiac Care: Read part 2 of our series on Virtual Reality.

Learn more about the innovative work we are doing at The Heart Center at Children's Health.

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