This Article Full Text Full Text (PDF) On-line Video Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kazumasa Orihashi Taijiro Sueda Kenji Okada Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Orihashi, K. Articles by Hamamoto, M. Search for Related Content PubMed PubMed Citation Articles by Orihashi, K. Articles by Hamamoto, M. Related Collections Cardiac - other Congenital - acyanotic Minimally invasive surgery

Real-time three dimensional echo-guided closure of atrial septal defect: an experimental model

Division of Cardiovascular Surgery, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan

*Corresponding author. Tel.: +81-82-257-5216; fax: +81-82-257-5219.

E-mail address: orichan{at}hiroshima-u.ac.jp (K. Orihashi).

Real-time 3D echo may open the way to off-pump closure of an atrial septal defect with a robotic surgery technique without remnant of closure device. We report the preliminary results of 3D echo-guided closure of defect in an experimental model. A sheet with an oval defect immersed in water was visualized with 3D echo as well as surgical instruments. The defect was closed under echo guidance. Visualization of objects and instruments, and feasibility and problems of this technique were examined. The defect was visualized like an endoscopic view. Changing the view point without moving the transducer was a unique advantage. Visualization of instruments was acceptable with the lowest gain level. Acoustic shadow was helpful for comprehending the spatial relationship among the objects. Position of needle entry could be confirmed by the movement of the sheet. As the defect was sutured, fold convergence appeared on the sheet. Difficulties were encountered in passing the needle between instruments because of echo dropout. The string was poorly visualized. 3D echo-guided suturing was feasible with adequate image quality. However, an improvement of the surface of instruments and a wider scanning area is necessary for achieving surgical procedures with more safety and reliability.

Key Words: Atrial septal defect; Three-dimensional echo; Minimally invasive surgery