Development and Application of a System Based on Artificial Intelligence for Transcatheter Aortic Prosthesis Selection
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2018
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| _version_ | 1876447123080216576 |
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| author | Álvaro M. Rösler |
| author_facet | Álvaro M. Rösler |
| contents | Development and Application of a System Based on Artificial Intelligence for Transcatheter Aortic Prosthesis Selection Álvaro M. Rösler Jonathan Fraportti Pedro Nectoux Gabriel Constantin Sílvio Cazella Mauro Ricardo Pontes Nunes Fernando A. Lucchese Medicina Expert System Aortic Valve Stenosis Artificial Intelligence Transcatheter Aortic Valve Replacement Introduction: The interest in Expert systems has increased in the medical area. Some of them are employed even for diagnosis. With the variability of transcatheter prostheses, the most appropriate choice can be complex. This scenario reveals an enabling environment for the use of an Expert system. The goal of the study was to develop an Expert system based on artificial intelligence for supporting the transcatheter aortic prosthesis selection.Methods: The system was developed on Expert SINTA. The rules were created according to anatomical parameters indicated by the manufacturing company. Annular aortic diameter, aortic area, aortic perimeter, ascending aorta diameter and Valsalva sinus diameter were considered. After performing system accuracy tests, it was applied in a retrospective cohort of 22 patients with submitted to the CoreValve prosthesis implantation. Then, the system indications were compared to the real heart team decisions.Results: For 10 (45.4%) of the 22 patients there was no concordance between the Expert system and the heart team. In all cases with discordance, the software was right in the indication. Then, the patients were stratified in two groups (same indication vs. divergent indication). The baseline characteristics did not show any significant difference. Mortality, stroke, acute myocardial infarction, atrial fibrillation, atrioventricular block, aortic regurgitation and prosthesis leak did not present differences. Therefore, the maximum aortic gradient in the post-procedure period washigher in the Divergent Indication group (23.9 mmHg vs. 11.9 mmHg, P=0.03), and the mean aortic gradient showed a similar trend.Conclusion: The utilization of the Expert system was accurate, showing good potential in the support of medical decision. Patients with divergent indication presented high post-procedure aortic gradients and, even without clinical repercussion, these parameters, when elevated, can lead to early prosthesis dysfunction and the necessity of reoperation. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442013 https://www.redalyc.org/journal/3989/398956442013/ https://www.redalyc.org/journal/3989/398956442013/html/ https://www.redalyc.org/journal/3989/398956442013/398956442013.epub https://www.redalyc.org/journal/3989/398956442013/movil 10.21470/1678-9741-2018-0072 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| format | Artículo científico |
| id | redalyc_398956442013 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Development and Application of a System Based on Artificial Intelligence for Transcatheter Aortic Prosthesis Selection Álvaro M. Rösler Medicina Expert System Aortic Valve Stenosis Artificial Intelligence Transcatheter Aortic Valve Replacement Development and Application of a System Based on Artificial Intelligence for Transcatheter Aortic Prosthesis Selection Álvaro M. Rösler Jonathan Fraportti Pedro Nectoux Gabriel Constantin Sílvio Cazella Mauro Ricardo Pontes Nunes Fernando A. Lucchese Medicina Expert System Aortic Valve Stenosis Artificial Intelligence Transcatheter Aortic Valve Replacement Introduction: The interest in Expert systems has increased in the medical area. Some of them are employed even for diagnosis. With the variability of transcatheter prostheses, the most appropriate choice can be complex. This scenario reveals an enabling environment for the use of an Expert system. The goal of the study was to develop an Expert system based on artificial intelligence for supporting the transcatheter aortic prosthesis selection.Methods: The system was developed on Expert SINTA. The rules were created according to anatomical parameters indicated by the manufacturing company. Annular aortic diameter, aortic area, aortic perimeter, ascending aorta diameter and Valsalva sinus diameter were considered. After performing system accuracy tests, it was applied in a retrospective cohort of 22 patients with submitted to the CoreValve prosthesis implantation. Then, the system indications were compared to the real heart team decisions.Results: For 10 (45.4%) of the 22 patients there was no concordance between the Expert system and the heart team. In all cases with discordance, the software was right in the indication. Then, the patients were stratified in two groups (same indication vs. divergent indication). The baseline characteristics did not show any significant difference. Mortality, stroke, acute myocardial infarction, atrial fibrillation, atrioventricular block, aortic regurgitation and prosthesis leak did not present differences. Therefore, the maximum aortic gradient in the post-procedure period washigher in the Divergent Indication group (23.9 mmHg vs. 11.9 mmHg, P=0.03), and the mean aortic gradient showed a similar trend.Conclusion: The utilization of the Expert system was accurate, showing good potential in the support of medical decision. Patients with divergent indication presented high post-procedure aortic gradients and, even without clinical repercussion, these parameters, when elevated, can lead to early prosthesis dysfunction and the necessity of reoperation. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442013 https://www.redalyc.org/journal/3989/398956442013/ https://www.redalyc.org/journal/3989/398956442013/html/ https://www.redalyc.org/journal/3989/398956442013/398956442013.epub https://www.redalyc.org/journal/3989/398956442013/movil 10.21470/1678-9741-2018-0072 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| title | Development and Application of a System Based on Artificial Intelligence for Transcatheter Aortic Prosthesis Selection |
| topic | Medicina Expert System Aortic Valve Stenosis Artificial Intelligence Transcatheter Aortic Valve Replacement |
| url | https://www.redalyc.org/articulo.oa?id=398956442013 https://www.redalyc.org/journal/3989/398956442013/ https://www.redalyc.org/journal/3989/398956442013/html/ https://www.redalyc.org/journal/3989/398956442013/398956442013.epub https://www.redalyc.org/journal/3989/398956442013/movil |