Validation of a laser projection platform for the preparation of surgical patches used in paediatric cardiac surgery

Abstract

Abstract OBJECTIVES Reconstruction of cardiovascular anatomy with patch material is integral to the repair of congenital heart disease. We present validation of a laser projection platform for the preparation of surgical patches as a proof-of-concept for intraoperative use in patient-specific planning of paediatric cardiac surgery reconstructions. METHODS The MicroLASERGUIDE, a compact laser projection system that displays computer-aided designs onto 2D/3D surfaces, serves as an alternative to physical templates. A non-inferiority comparison of dimensional measurements was conducted between laser projection (‘laser’) and OZAKI AVNeo Template (‘template’) methods in creation of 51 (each group) size 13 valve leaflets from unfixed bovine pericardium. A digital version of the OZAKI AVNeo Template dimensions served as control. Feasibility testing was performed with other common patch materials (fixed bovine pericardium, PTFE and porcine main pulmonary artery as a substitute for pulmonary homograft) and sizes (13, 23) (n = 3 each group). RESULTS Compared to control (height 21.5, length 21.0 mm), template height and length were smaller (height and length differences of −0.3 [−0.5 to 0.0] and −0.4 [−0.8 to −0.1] mm, P < 0.01 each); whereas, both laser height and length were relatively similar (height and length differences of height 0.0 [−0.2 to 0.2], P = 0.804, and 0.2 [−0.1 to 0.4] mm, P = 0.029). Template percent error for height and length was −1.5 (−2.3 to 0.0)% and −1.9 (−3.7 to −0.6)% vs 0.2 (−1.0 to 1.1)% and 1.0 (−0.5 to 1.8)% for the laser. Similar results were found with other materials and sizes. Overall, laser sample dimensions differed by a maximum of 5% (∼1 mm) from the control. CONCLUSIONS The laser projection platform has demonstrated promise as an alternative methodology for the preparation of surgical patches for use in cardiac surgery. This technology has potential to revolutionize preoperative surgical planning for numerous congenital anomalies that require patient-specific patch-augmented repair.