Proposal for Valve Sizing, Prosthesis Simulation, and Procedure Planning Based on Computed Tomography in Endoscopic Mitral Valve Surgery

In endoscopic mitral valve repair and replacement, direct valve sizing is impractical because skin incisions have become very small and do not fit traditional sizers. Until now, procedure planning using dedicated computed tomography (CT) software has not been the standard of care. However, proper CT analysis can help anticipate procedural challenges and enhance procedure planning in endoscopic mitral valve surgery. Cannulation and valve implantation strategy may be chosen, risk of injury to the circumflex artery as well as left ventricular outflow tract obstruction may be anticipated, and digital phantoms of surgical prostheses may be simulated inside the annulus. We propose digital simulation and procedure planning for surgeons by CT-based reconstructions.