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Proceedings Paper

Integration of a biomechanical simulation for mitral valve reconstruction into a knowledge-based surgery assistance system
Author(s): Nicolai Schoch; Sandy Engelhardt; Norbert Zimmermann; Stefanie Speidel; Raffaele De Simone; Ivo Wolf; Vincent Heuveline
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Paper Abstract

A mitral valve reconstruction (MVR) is a complex operation in which the functionality of incompetent mitral valves is re-established by applying surgical techniques. This work deals with predictive biomechanical simulations of operation scenarios for an MVR, and the simulation's integration into a knowledge-based surgery assistance system. We present a framework for the definition of the corresponding surgical workflow, which combines semantically enriched surgical expert knowledge with a biomechanical simulation. Using an ontology, 'surgical rules' which describe decision and assessment criteria for surgical decision-making are represented in a knowledge base. Through reasoning these 'rules' can then be applied on patient-specific data in order to be converted into boundary conditions for the biomechanical soft tissue simulation, which is based on the Finite Elements Method (FEM). The simulation, which is implemented in the open-source C++ FEM software HiFlow3, is controlled via the Medical Simulation Markup Language (MSML), and makes use of High Performance Computing (HPC) methods to cope with real-time requirements in surgery. The simulation results are presented to surgeons to assess the quality of the virtual reconstruction and the consequential remedial effects on the mitral valve and its functionality. The whole setup has the potential to support the intraoperative decision-making process during MVR where the surgeon usually has to make fundamental decision under time pressure.

Paper Details

Date Published: 18 March 2015
PDF: 7 pages
Proc. SPIE 9415, Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling, 941502 (18 March 2015); doi: 10.1117/12.2082153
Show Author Affiliations
Nicolai Schoch, Heidelberg Univ. (Germany)
Sandy Engelhardt, German Cancer Research Ctr. (DKFZ) (Germany)
Norbert Zimmermann, Univ. Hospital Heidelberg (Germany)
Stefanie Speidel, Karlsruher Institut für Technologie (Germany)
Raffaele De Simone, Univ. Hospital Heidelberg (Germany)
Ivo Wolf, German Cancer Research Ctr. (DKFZ) (Germany)
Mannheim Univ. of Applied Sciences (Germany)
Vincent Heuveline, Heidelberg Univ. (Germany)


Published in SPIE Proceedings Vol. 9415:
Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling
Robert J. Webster; Ziv R. Yaniv, Editor(s)

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