Contrast Pericardiography Facilitates Intrapericardial Navigation Under Fluoroscopy

Cohn, William E.; Winkler, Jo Anna; Tüzün, Egemen; Hjelle, Aaron; Bassett, Kevin; Ahmad, Abdolhaliem; Frazier, O.H.

doi:10.1016/j.athoracsur.2010.06.025

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…diameter) incision at the pericardial apex, and then constructed a pericardial cradle to stabilize the pericardial edges. A pericardiogram was performed for imaging of the epicardial structures by infusing contrast media directly into the pericardial sac through the apical incision [ 5 ]. Prior to deployment, the device was compressed into a cylindrical deployment tube (PTFE 2.5 cm OD, 2.3 cm ID, 20 cm length), with radiopaque marker tape used to visualize the end of the tube under fluoroscopic imaging (Indicator® 1.0 mm Lines–IZI Medical Products).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the CorInnova Heart Assist Device in an Acute Heart Failure Model

Hord

Bolch²,

Tüzün

et al. 2019

J. of Cardiovasc. Trans. Res.

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While the number of patients supported with temporary cardiac assist is growing, the existing devices are limited by a multitude of complications, mostly related to contact with the blood. The CorInnova epicardial compressive heart assist device was tested in six sheep using an acute heart failure model. High esmolol dose, targeting a 50% reduction in CO from healthy baseline, resulted in a failure state with mean CO 1.9 L/min. Heart assist with the device during failure state resulted in an average absolute increase in CO of 1.0 L/min, along with a decline in ventricular work to 67.5% of the total LV SW. Combined with repeated success of minimally invasive device implant, the resulting increases in cardiac hemodynamics achieved while still unloading the heart demonstrate the potential of the CorInnova device for temporary heart assist. Electronic supplementary material The online version of this article (10.1007/s12265-018-9854-5) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Evaluation of the CorInnova Heart Assist Device in an Acute Heart Failure Model

Hord

Bolch²,

Tüzün

et al. 2019

J. of Cardiovasc. Trans. Res.

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“…Pericardial iodinated contrast has been shown to facilitate navigation within the pericardial space . Important structures such as atrial appendages, right ventricular outflow tract or atrioventricular groove can be delineated.…”

Section: Discussionmentioning

confidence: 99%

Intentional right atrial exit for microcatheter infusion of pericardial carbon dioxide or iodinated contrast to facilitate sub‐xiphoid access

Rogers

Ratnayaka

Schenke

et al. 2014

Cathet Cardio Intervent

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Objectives We test the safety of trans-atrial pericardial access using small catheters, infusion of carbon dioxide (CO2) or iodinated contrast to facilitate sub-xiphoid access, and catheter withdrawal under full anticoagulation. Background Sub-xiphoid pericardial access is required for electrophysiological and structural heart interventions. If present, an effusion protects the heart from needle injury by separating the myocardium from the pericardium. However, if the pericardium is ‘dry’ then there is a significant risk of right ventricle or coronary artery laceration caused by the heart beating against the needle tip. Intentional right atrial exit is an alternative pericardial access route, through which contrast media could be infused to separate pericardial layers. Methods Trans-atrial pericardial access was obtained in a total of 30 Yorkshire swine using 4Fr or 2.8Fr catheters. In 16 animals, trans-atrial catheters were withdrawn under anticoagulation and MRI was performed to monitor for pericardial hemorrhage. In 14 animals, iodinated contrast or CO2 was infused before sub-xiphoid access was obtained. Results Small effusions (mean 18.5mL) were observed after 4Fr (1.3mm outer-diameter) but not after 2.8Fr (0.9mm outer-diameter) trans-atrial catheter withdrawal despite full anticoagulation (mean activated clotting time 383sec), with no hemodynamic compromise. Pericardial CO2 resorbed spontaneously within 15min. Conclusions Intentional trans-atrial exit into the pericardium using small catheters is safe and permits infusion of CO2 or iodinated contrast to separate pericardial layers and facilitate sub-xiphoid access. This reduces the risk of right ventricular or coronary artery laceration. 2.8Fr trans-atrial catheter withdrawal does not cause any pericardial hemorrhage, even under full anticoagulation.

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“…Pericardial iodinated contrast has been shown to facilitate navigation within the pericardial space [21]. Important structures such as atrial appendages, right ventricular outflow tract or atrioventricular groove can be delineated.…”

Section: Pericardial Contrast Mediamentioning

confidence: 99%