3D TAVR Anatomy Prediction for Pacemaker Need Assessment
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Solution Overview
Problem
Existing methods for predicting the need for a pacemaker after a transcatheter aortic valve replacement (TAVR) procedure are inaccurate, leading to potential conduction system damage and subsequent arrhythmias, as they do not account for specific anatomical factors that may increase the risk of conduction system disturbance during the procedure.
Innovation Solution
A computer-implemented method using 3D imaging and machine learning to predict the likelihood of requiring a pacemaker post-TAVR by analyzing parameters such as the depth of the membranous septum, angle of rotation of the aortic valve cusps, and left ventricle-aorta angulation, allowing for pre-operative pacemaker implantation when necessary.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If existing prediction methods are used, then the procedure can be performed without additional imaging analysis, but the accuracy of predicting pacemaker need is insufficient leading to potential conduction system damage
Solution Approach 1:
The patent applies preliminary action by performing 3D imaging analysis and calculating anatomical parameters (membranous septum depth, aortic valve cusp rotation angle, LV-aorta angulation) before the TAVR procedure. This preoperative assessment allows prediction of conduction system damage risk and pacemaker need before the intervention, enabling proactive planning and improved prediction accuracy.
Solution Approach 2:
The patent uses 3D imaging technology and computational algorithms as intermediaries between the anatomical structures and the prediction outcome. The 3D images serve as a mediator to visualize and measure critical anatomical parameters that are not directly observable, transforming them into quantifiable data for prediction models.
2Productivity
If pacemaker implantation is performed as a separate surgical step, then the procedure can be completed sequentially, but procedure efficiency decreases and costs increase
Solution Approach 1:
The patent merges the prediction and planning phases with the actual TAVR procedure. By using 3D imaging and anatomical parameter calculation before the procedure, the system integrates prediction, planning, and execution into a coordinated workflow, eliminating the need for separate pacemaker implantation surgery when predicted, thereby improving efficiency and reducing costs.
Solution Approach 2:
The patent performs preliminary identification of patients at risk for conduction system damage through 3D imaging analysis before the TAVR procedure. This allows the surgical team to plan for combined TAVR and pacemaker implantation in advance, streamlining the overall surgical process and avoiding sequential procedures.
3Reliability
If 3D imaging and anatomical parameter analysis are performed, then the prediction accuracy for conduction system damage risk is improved, but the complexity of preoperative assessment increases
Solution Approach 1:
The patent segments the complex anatomical structure into key measurable parameters: membranous septum depth, aortic valve cusp rotation angle, and LV-aorta angulation. By breaking down the complex 3D anatomy into discrete, quantifiable parameters, the system maintains high prediction reliability while making the assessment process more manageable and systematic.
Solution Approach 2:
The patent replaces manual anatomical assessment with automated 3D imaging analysis and computational algorithms. The mechanical system of manual measurement and estimation is substituted with digital 3D reconstruction and algorithmic calculation, improving reliability while standardizing the assessment process.
Data Source
AI summary
There is provided a computer implemented method of predicting likelihood of a subject requiring a pacemaker after a transcatheter aortic valve replacement (TAVR) procedure, comprising: computing from a 3D image of a subject at least one parameter selected from: (i) a depth of a membranous septum computed as a distance between the membranous septum and a virtual annulus plane of a native aortic valve, (ii) an angle of rotation of at least one cusp of the native aortic valve relative to the membranous septum, and (iii) a left ventricle (LV)—aorta angulation, and computing a prediction of likelihood of the subject requiring the pacemaker after the TAVR according to the at least one parameter.