Excimer laser ablation for valvular angioplasty in pulmonary atresia and intact ventricular septum

Moskowitz, William B.; Titus, Jack L.; Topaz, On

doi:10.1002/lsm.20106

Cited by 9 publications

(2 citation statements)

References 38 publications

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“…Transcatheter intervention therapies, which include radio frequency (RF), microwave (WMA), laser, and cryoablation, have been extensively studied for the treatment of cardiac diseases, such as atrial fibrillation [ 9 ], ventricular tachycardia [ 10 , 11 ], and pulmonary atresia [ 12 ]. Regarding septal ablation, the advantages of transcatheter RF ablation over ethanol ablation and myectomy include high accuracy and low risk of damaging the conduction system [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Echocardiography-guided percutaneous per-ventricular laser ablation of ventricular septum: in vivo study in a canine model

Sun

Zhang

et al. 2016

Lasers Med Sci

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Surgical myectomy and ethanol ablation are established intervention strategies for left ventricular outflow obstruction in hypertrophic cardiomyopathy. Safety and efficacy limitations of these interventions call for a minimally invasive, potentially safer, and more efficacious strategy. In this study, we aimed to evaluate the feasibility of echocardiography-guided percutaneous per-ventricular laser ablation of a ventricular septum in a canine model. Six domestic dogs were chosen for the study. A 21G needle was inserted into the right ventricle with its tip reaching the targeted basal to mid-septum, after which laser ablation was performed as follows: 1-W laser for 3 min (180 J) at the basal segment and 5 min (300 J) at middle segment of the septum, respectively. Echocardiography, blood chemistry tests, and pathology examination were performed to assess the results of laser ablation. No death or major complications, i.e., tamponade, pericardial effusion, or ventricular fibrillation, occurred. The laser-ablated areas were well demarcated in the results of the pathological examination. The diameters of the ablated regions were 4.42 ± 0.57 and 5.28 ± 0.83 mm for 3 and 5 min ablation, respectively. Pre-ablation and post-ablation, cardiac enzymes were found to increase significantly while no significant differences were found among M-mode, 2D (LVEF), pulsed-wave (PW) Doppler, and tissue Doppler imaging (TDI) measurements. Contrast echocardiography confirmed the perfusion defects in the ablated regions. Microscopically, the ablated myocardium showed coagulative changes and a sparse distribution of disappearing nuclei and an increase in eosinophil number were observed. Our study suggests that percutaneous and per-ventricular laser ablation of the septum is feasible, potentially safe and efficacious, and warrants further investigation and validation.

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Section: Introductionmentioning

confidence: 99%

Echocardiography-guided percutaneous per-ventricular laser ablation of ventricular septum: in vivo study in a canine model

Sun

Zhang

et al. 2016

Lasers Med Sci

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show abstract

“…This modified technique was developed by Professor Giancarlo Biamino in Germany, who instructed its application to many interventionalists around the world. To date, it has been successfully applied in peripheral angioplasty [7], in selected cases of coronary revascularization [8], and even in the treatment of congenital heart anomalies [9]. It is imperative to realize that whether the operator utilizes Biamino's technique or the traditional “pulse and retreat” coronary lasing technique [10, 11], the advancement rate of the laser catheter is a key component of the procedure.…”

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confidence: 99%