Endometrial thermal balloon ablation under local anesthesia in patients with prosthetic heart valves: A pilot study

Abstract

We treated eleven cases of high risk surgical candidate women with prosthetic heart valves, complaining of menorrhagia, by thermal balloon ablation under local anesthesia after pharmacological endometrial thinning. Menorrhagia was documented by a validated pad scoring system. All patients were severely anemic at presentation. Nine of them had one valve replaced among these cases, two were restenosic at presentation, one had twice mitral valve replacement. Two of them had two valves replaced. All procedures were performed under local anesthesia supplemented by analgesics, no complications were observed either intraoperatively or during the follow-up of at least 24 months. After two years, thermal balloon ablation proved to be statistically significantly effective in terms of pad score reduction; two patients reported spotting and the rest was hypomenorrheic, none of the group experienced amenorrhea. This technique proved to be safe, feasible and effective under this clinical circumstances.

A randomized controlled trial of levonorgestrel releasing IUD and thermal balloon ablation in the treatment of menorrhagia

“…It was technically simple and almost free of intraoperative complications [22]. In high-risk surgical candidates it was found to be effective [1,28]. Its short and long term consistent results and efficacy are proven and can be performed as an out-patient procedure under local anesthesia [7 ± 9, 11, 19].…”

Conductive interstitial thermal therapy device for surgical margin ablation:In vivoverification of a theoretical model

“…Thermal ablation of tumours and margins is gaining acceptance as complementary treatment in the management of solid tumours [2,22,23,25,26,[74][75][76][77][78][79]. Herein we present a patented device, conductive interstitial thermal therapy device (CITT), for soft tissue ablation [39,40].…”

“…Under constant pressure of 80-200 mm Hg, the fluid is heated to 75-92 C through heating elements inside the balloon for 7-12 min. Thermal balloon endometrial ablation is considered safe and effective, in comparison to endometrial ablation using laser or radiofrequency [42,[74][75][76]. The CITT device is based on the same physical principles as balloon ablation.…”

Thermal Balloon Endometrial Ablation: A Safe and Effective Modality for Treatment of Dysfunctional Menorrhagia

“…In view of this fact, no medical or surgical pre-treatment endometrial thinning was used in the Preliminary studies demonstrated the safety and efficacy of thermal balloon endometrial ablation in medically and surgically risk patients (19,20).…”