The important thing with MIDCAB is choosing the right surgical path, which can go through the fourth intercostal space or, just as well, the fifth, explains Van Linden. In medicine, these image reconstructions are most often computed based on contrast-enhanced CT scans, although MRI data would also be suitable.

CR comes from the film industry (hence the name) and allows, for example, computer-animated figures to appear exceptionally true to life. “The images really look just like what you see later in the operation.” This realistic depiction is based on a specific image-synthesis algorithm. “Thanks to CR, we can get a virtual look inside the chest cavity, assess the layout of the vessels, view the heart from the side or from above – and then determine the ideal access point for the operation,” says Van Linden. In these operations, known as MIDCAB (minimally invasive direct coronary artery bypass), an additional vascular conduit is created on the heart via a small incision in the chest wall. Van Linden, a cardiac surgeon, is testing cinematic rendering (CR) for the planning of minimally invasive bypass operations. “The more vivid the imaging, the better it is for the surgeon,” confirms Arnaud Van Linden of the University Hospital Frankfurt, Germany.

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