Cardiologists at the Dutch St. Antonius Heart Centre have recently started using artificial intelligence during procedures to repair leaky heart valves. The new DeviceGuide software has been developed by the Dutch St. Antonius Heart Centre, Philips and Edwards Lifesciences. It combines live X-ray images with ultrasound scans, enabling doctors to see more clearly where the instrument is located within the heart. This should make the treatment more precise. According to the hospital, the new application can make the procedure faster and more targeted.
Some people have a leaking mitral valve in the heart. This is one of the four valves that ensures blood flows in the right direction. If this valve does not close properly, blood flows in the wrong direction. This requires the heart to expend a great deal of extra energy. People with a leaking heart valve therefore often feel tired and short of breath even after minimal exertion. In severe cases, the condition can ultimately lead to heart failure.
Minimally invasive alternatives
Whereas a leaky heart valve used to be treatable only through open-heart surgery, less invasive alternatives are now available. In a so-called minimally invasive procedure, the cardiologist inserts a thin tube through the blood vessels to the heart via a small incision in the groin. At the tip of the tube is a clip that can be used to repair the leaky heart valve.
This treatment was first carried out in the Netherlands in 2009 at the St. Antonius Heart Centre. As the sternum does not need to be opened during the procedure, recovery is usually quicker than after traditional surgery.
Navigating the heart
Cardiologist Leo Timmers explains that the challenge with this type of operation is that the small clip is not immediately visible. During the operation, Timmers looks at a screen displaying X-ray images and ultrasound scans that show the inside of the heart. “Those images can sometimes be difficult to interpret, particularly as the heart continues to beat during the procedure and the image is therefore constantly moving,” explains Timmers.
“The new AI technology, DeviceGuide, is changing that,” says Martin Swaans, a cardiologist specialising in cardiac imaging. “This software tracks the clip as it moves through the beating heart. It creates a clear 3D image on which the doctor can see exactly where the clip is located and in which direction it is pointing.” He compares it to a car sat-nav: the doctor can not only see where the clip is, but also get a better sense of the direction in which it is moving.
Co-production
DeviceGuide was developed by the St. Antonius Heart Centre, Philips and Edwards Lifesciences. The launch of the technology also attracted international attention. On 16 June, a group of foreign journalists visited the heart centre at the invitation of Philips. They spoke to cardiologists and, with the patients’ consent, observed a procedure in which the new software was used. A second visit by international media is planned for later this year.
Philips has developed the new AI software to support doctors during complex heart valve operations. The system, DeviceGuide, was launched at the end of last year and utilises real-time 3D images. According to Philips, the software combines various image sources into a single shared visualisation. This enables all specialists in the cath lab, from interventional cardiologists to echocardiographers, to view the same up-to-date images simultaneously, which should improve collaboration during the procedure.
References
St. Antonius Hospital (in Dutch)
