Computer-Assisted Open Heart CABG: Image-Guided Navigation for All Target Vessels

During open heart coronary artery bypass grafting (CABG), optimal placement of the bypass graft on the diseased target vessel is of utmost importance. To assist the heart surgeon in this matter, a surgical navigation system has been developed. The concept includes preprocedural planning of the optimal position for the distal anastomosis (surgical target) on the target vessel and intraoperative image-guided navigation to that position. Navigation is enabled by registration of pre- and intraoperative data. The registration mechanism was validated retrospectively. Promising results justified subsequent intraoperative live application of the system during 11 open heart CABG surgeries enabling navigation on 21 target vessels on the anterior, lateral and inferior wall of the heart. In each case, the employed registration mechanism ensured good alignment of preoperatively planned and intraoperatively identified surgical targets. The system is very well applicable for in-vivo navigation and allows for bypass grafting precisely at a preoperatively planned position.