Apple Vision Pro Spatial Computing for Endoscopic Mitral Valve and VSD Surgery

Videos of the CT scan, transesophageal echocardiography, and coronary angiography were acquired with an iPhone 15 Pro and transferred to the Vision Pro device through the AirDrop application. Windows were opened in the space surrounding the endoscopic system. This made intraoperative consultation of imaging tests with gestures and sharing of the procedure via steaming possible. 

Using a endoscopic right minithoracotomy, the anterior leaflet of the mitral valve was detached through its basal portion and the VSD was identified and closed by separate 5/0 polypropylene sutures. 

Subsequently, the anterior leaflet was resutured with separate 5/0 polypropylene sutures and an annuloplasty was performed by positioning a 40 mm open band fixed with the automatic Cor-Knot system. Finally, a posterior leaflet triangular resection was performed guided by online consultation of the 3D TEE. 

The procedure was completed successfully without any complications and the patient had an uneventful recovery. A postoperative echocardiography showed an absence of mitral regurgitation and an absence of left to right interventricular shunt. 

References

1. Maselli D, Nardella S, Santise G, Iavazzo A, Chiariello L. , «Micro-Invasive 3D Endoscopic Mitral Valve Surgery.,» Surg Technol Int., Vol. %1 di %240:227-234. , 2022.
2. Nayak S, Patel A, Haddad L, Kanakriyeh M, Varadarajan P, «Echocardiographic evaluation of ventricular septal defects.,» Echocardiography, Vol. %1 di %237(12):2185-2193. , 2020.

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