One way to boost performance in an underachieving or aging heart is to get a valve replacement. In the old days that meant a huge surgery and the better part of a year to fully recover. Valve suppliers that want to move product have recently come up with a much better option that combines catheter-based delivery with cutting edge imaging and presurgical stimulation. The entire process can now repair the heart in a few hours and have you back on your feet within a few days.
The valves themselves are fairly standard; chemically treated pig valve leaflets buttressed on a delicate nitinol frame. The real magic is getting the new hardware inside. As you can see in the video below its all done through catheters now. Access to the aortic valve is gained through the femoral artery in the groin that is fed up to heart. A balloon actuator is used to simply compress the old valve out of the way and the new one is popped in place and expanded till it is snug. If the surgeon isn’t happy with the fit, they simply put the antelope back into the python, so to speak, and the procedure repeated.
Never mind the beating heart, that can be controlled as well. The surgeons can slow the normal beating with various drugs and then pace its rhythm as needed through an additional catheter threaded in through the neck. Like an elite marksman accurately firing in the lull between heartbeats, internal sources of positioning error can therefore be minimized.
Making this all possible are several new technologies that ensure there are no surprises. Each patient’s unique vasculature can be pre-imaged and fully mocked-up in a simulation that lets the entire procedure by rehearsed ahead of time.
In one recent Silicon Valley procedure Dr. Christian Assad was able to document the entire valve replacement surgery with help of a pair of ODG smart glasses. Made available through a collaboration with VitalMedicals, the glasses also serve as an angiographic monitor and act as a telecommunications hub to external support.
The demands in imaging and displaying surgical details are not trivial. Although Google Glass has found several applications in the OR, as a primary hands free optic for an operating surgeon the mechanics of the device are simply not optimized to the task. The main issues of concern for surgical glasses are control of focus and view direction (a gaze orientation more downward rather than forward), battery power and location, and illumination.
As for the ODG glasses, they are still largely an industrial solution at the present time. However, there is a consumer version that will be released next your for around $2700. It will run Android KitKat and feature two stereoscopic 720p displays running at 80 frames per second. It will also have a four-megapixel forward-facing camera that can record in 1080p at 60 frames per second.
The extra visual and data streams afforded by devices like smart glasses are obviously not the core technology here in advancing heart valve replacements. As conduits of essential technical details both into and out of the surgical theater, however, they may be the meta-technology that enables new primary technology to gain a foothold in the OR.
