Objectives To investigate how virtual reality (VR) imaging impacts decision-making in atrioventricular valve surgery. Methods This was a single centre retrospective case- crossover study involving 18 children and adolescents - median age 6 years (range 0.33 - 16) requiring surgical repair of the atrioventricular valves between 2016-2019. The patients’ pre-operative 3D echocardiographic data were used to create 3D visualisation in a VR application. Five paediatric cardiothoracic surgeons completed a questionnaire formulated to compare their surgical decisions regarding the cases after reviewing conventionally presented 2D and 3D echocardiographic images and again after visualisation of 3D echocardiograms using the VR platform. Results In 67% of cases presented with VR, surgeons reported having “more” or “much more” confidence in their understanding of each patient’s pathology and their surgical approach. In all but one case, surgeons were at least as confident after reviewing the VR compared to standard imaging. The case where surgeons reported to be least confident on VR had the worst technical quality of data used. After viewing patient cases on VR, surgeons reported that they would have made minor modifications to surgical approach in 53% and major modifications in 7% of cases. Conclusion The main impact of viewing imaging on VR is the improved clarity of the anatomical structures. Surgeons reported that this would have impacted the surgical approach in the majority of cases. Poor quality 3D echocardiographic data was associated with a negative impact of VR visualisation, thus quality assessment of imaging is necessary before projecting in a VR format.
|Publication status||Accepted/In press - 19 Feb 2021|