Minimally invasive cardiovascular surgery has been brought to a higher level of efficiency, precision and safety for the patient by using artificial intelligence for the endovascular prosthesis of the abdominal aorta, a first for Romania, at the SANADOR Clinical Hospital. The interventions carried out by the team led by Prof. Dr. Victor Costache took place in the first fully digitized operating room in Romania, with the help of the mobile angiograph and the intraoperative fusion and navigation system based on artificial intelligence.
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“We continue the series of awards from the Center of Excellence and Training in Minimally Invasive Cardiovascular Surgery at the SANADOR Clinical Hospital, the only one in Romania internationally accredited, by using a system based on artificial intelligence, for the maximum benefit of our patients. We started with several endovascular aortic aneurysm repair procedures, the so-called EVAR procedure, but we will expand AI-assisted treatments for peripheral arterial disease as well as transcatheter valve repair or replacement procedures. In this way, we reduce to less than a third the contrast material required during procedures and also greatly reduce intraprocedural irradiation, while adding a higher level of safety“, he declares Prof. Dr. Victor Costachehead of the Department of Cardiovascular Surgery at the SANADOR Clinical Hospital.
How is artificial intelligence used in the operating room?
The mobile hybrid room at the SANADOR Clinical Hospital is equipped with the Ziehm Vision RFD Hybrid Edition mobile angiograph and the EndoNaut artificial intelligence system, an extremely powerful combination, through which the capabilities of a traditional fixed angiography room can be obtained in the digitized operating room. The EndoNaut system fuses the preoperative CT images with the fluoroscopic images obtained by the mobile angiographer in real time, resulting in a three-dimensional vascular reconstruction superior to the 2D images obtained by a conventional angiographer.
3D fusion of intraoperative images is of great help for complex structural procedures such as EVAR, TEVAR (thoracic aortic aneurysm endovascular repair) or TAVI (transcatheter aortic valve replacement), and the maximum benefit is obtained in complicated procedures such as EVAR fenestrated or branched, in which endovascular prostheses customized for each patient's anatomy are used, where maximum precision is mandatory. In addition, the surgeon has access to the EndoNaut system interface throughout the procedure, fully controlling each step of the procedure and adding additional measurements at any time.
The artificial intelligence system in the mobile hybrid room allows for detailed pre-operative planning of the procedure, which means increased patient safety, but also reduced operating times, in addition to greatly reduced irradiation and a much smaller volume of contrast material required compared to procedures performed in the Angiography Laboratory. By reducing the volume of the contrast material, increased protection of the patient's renal function is achieved.
For the exact determination of the endovascular prosthesis needed for each patient, SANADOR doctors use the EndoSize system, which quickly and with maximum accuracy identifies the right vascular prosthesis, eliminating any risk of error.
Exceptional facilities at the SANADOR Clinical Hospital
This new national premiere at the SANADOR Clinical Hospital is possible thanks to the exceptional facilities in the first fully digitized operating theater in Romania. The operating rooms are equipped with several large mobile monitors, a control console near the operating table and a fixed central system with a large monitor. Any of the images requested by the surgeon can be projected on each screen: the 4K image filmed by the camera on the main lamp, the one on the ceiling camera or the 4K camera of the operating videoendoscope. In addition, information from the patient's electronic record can be projected on any of the monitors, including the results of previous imaging investigations, but also images provided by auxiliary sources, such as the mobile angiograph, the echocardiograph, the intensive care monitor with vital signs.
The operating rooms are equipped with radiotransparent operating tables, with a carbon top, which ensure a total 360-degree radiotransparency. Thus, the rooms can become a mobile hybrid room when the operating team uses the Ziehm Vision RFD Hybrid Edition mobile angiograph, the most advanced mobile C-arm model currently available in the world, introduced for the first time in Romania at the SANADOR Clinical Hospital. By using the EndoNaut console, based on artificial intelligence, and the EndoSize system, doctors can perform highly complex endovascular procedures in complete patient safety.
Complex cardiovascular interventions at the SANADOR Clinical Hospital are also possible thanks to the category I Department of Anesthesia and Intensive Care, with an extensive level of competence, prepared for any situation. The cardiovascular intensive care unit has state-of-the-art equipment, including ECMO (the so-called “artificial lung”), computer-integrated into a digital platform.
The center of excellence and training in minimally invasive cardiovascular surgery at the SANADOR Clinical Hospital is the first in Romania to be internationally accredited.
Founded in 2001, SANADOR has experienced continuous organic development, currently owning the largest private multidisciplinary clinical hospital in the country, a complex oncology center, clinics, medical analysis laboratories and collection points, radiology and high-performance medical imaging, located in Bucharest. The SANADOR Clinic Hospital is the only private hospital that provides a complex range of medical services, including major surgery, with the support of the ATI Level I Department, but also medical and surgical emergencies through the Adult and Children Emergency Reception Department, non-stop imaging, 25 lines of guard and own fleet of ambulances.
