Holography in Congenital Heart Disease: Diagnosis and Transcatheter Treatment

The heart is comprised of three-dimensional components whose size, shape, and spatial interrelationships constantly change in an organized rhythmic fashion. The field of congenital heart disease encompasses the result of a disruption of the normal, but complex, three-dimensional internal anatomy and functioning of the heart. The diagnosis and treatment of congenital heart defects demand a precise and profound understanding of this dynamic anatomy and are therefore heavily reliant on real-time imaging. The open-heart surgeon has the benefit of comprehension and interaction with the real 3D anatomy; however this is usually static during open-heart surgery. The interventionalist wishing to employ minimally invasive transcatheter techniques in the beating heart has to build a mental concept of the anatomy usually derived from 2D echocardiographic and fluoroscopic data displayed on a screen. In general, the surgeon’s understanding of the anatomy is more complete and intuitive than that of the interventionalist even though they may be performing similar procedures, e.g., closure of an ASD secundum. In an attempt to bridge that gap, high-quality 3D volumetric data acquisition systems such as 3D transthoracic and transesophageal echocardiography, 3D rotational angiography, CT, and MRI have been developed. However this volumetric data is typically displayed on 2D screens which restrict the image to a single plane of view, preclude interaction directly with the image, and hamper the perception of depth. The development of a simple, accurate, and accessible 3D display for these data is a challenge, especially when attempting to display true depth.