Septal Reduction Using Transvenous Intramyocardial Cerclage Radiofrequency Ablation

Shin, Eun‐Seok; Chon, Min-Ku; Jun, Eun Jung; Park, Yong-Hyun; Lee, Sang‐Hyun; Kim, Jeong‐Su; Shin, Dong-Hun; Lee, Soo-Yong; Cho, Min Soo; Lee, Seung-Whan; Reinthaler, Markus; Park, Jai‐Wun; Nam, Gi-Byung; Lederman, Robert J.; Won, Yonghyun; Kim, June‐Hong

doi:10.1016/j.jacbts.2020.08.006

Cited by 8 publications

(3 citation statements)

References 26 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, this study represents the first description of percutaneous ultrasound-guided RFA of CDs in either veterinary or human medicine. In humans, this technique has been used to alleviate myocardial hypertrophy [58][59][60] and to treat neuroendocrine tumors, such as paragangliomas, in different locations [61][62][63]. Percutaneous ultrasound-guided RFA has been reported for treatment of parathyroid and thyroid masses in dogs [42][43][44][45] and cats [46], respectively.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

Ochoa

Alférez²,

Blas

et al. 2021

Animals

View full text Add to dashboard Cite

Chemodectomas are low prevalence tumors with complex clinical management. Many present as an incidental finding however, in other dogs, they produce pericardial effusion and/or compression, leading to the appearance of severe clinical signs. There are currently several approaches: surgery, radiotherapy, stent placement and chemotherapy. This is the first description of percutaneous echo-guided radiofrequency ablation of aortic body tumors. This minimally invasive treatment is based on high frequency alternating electrical currents from an electrode that produces ionic agitation and generates frictional heat, causing coagulation necrosis. Five dogs with an echocardiographic and cytological diagnosis of chemodectoma underwent percutaneous echo-guided radiofrequency ablation. At the time of presentation, all the dogs showed clinical signs, such as ascites and/or collapse. There were no complications either during the procedure or in the following 24 hours. Rapid clinical improvement associated with a reduction in size and change in sonographic appearance of the mass were achieved with no complications. Six months follow-up was carried out in all dogs. A second percutaneous echo-guided RFA was performed eight months after the first procedure in one dog. Based on our experience, radiofrequency ablation seems to be a feasible and safe technique, making it a potential alternative therapeutic approach in the clinical management of aortic body tumors leading to severe clinical compromise.

show abstract

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

Ochoa

Alférez²,

Blas

et al. 2021

Animals

View full text Add to dashboard Cite

show abstract

“…Additionally, septal para-hisian pacing has been proposed as an alternative treatment option employing a similar approach. Imaging guidance, particularly through preprocedural cardiac CT scans, plays a pivotal role in visualizing the anatomy of septal veins [ 5 , 6 , 7 ]. It serves as a key imaging tool for determining and planning the procedure in advance.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Computed Tomography Identification of the Septal Vein—A Small Retrospective Study

Chon,

Choo,

Kim

2024

Life

View full text Add to dashboard Cite

Background: The advancement of medical interventions towards minimally invasive procedures highlights the crucial role of precise pre-procedural evaluation, particularly in catheter-based treatments for heart and cardiovascular conditions. This study investigates innovative techniques such as mitral loop cerclage (MLC) and transcatheter intramyocardial radiofrequency ablation (TIRA), emphasizing the importance of preprocedural cardiac CT scans for accurate anatomical guidance in these emerging therapies. Purpose: The objective of this study was to assess the cardiac cycle through examination of the proximal septal vein (ps) for mitral loop cerclage and the distal septal vein (ds) for transcatheter intramyocardial radiofrequency ablation. Materials and Methods: Forty patients (mean age 59.4 ± 14.7 years) undergoing third-generation dual-source computed tomography (DSCT) for chest pain evaluation were enrolled. CT scans, utilizing dual-energy CT (DECT) with iopamidol and saline, encompassed the carina to the heart base. A noise-optimized linear blended image was reconstructed at 10% intervals throughout the cardiac cycle, and the presence of ps and ds in each phase was noted by two radiologists. Results: This study identified ps in 62.5% and ds in 72.5% of patients, with both present in 45% of cases. The observation of septal veins occurred more frequently in the sequence of 70, 60, 40, 80, 30, 20, and 10% for ps, and 60, 70, 40, 80, 30, 90, 20, and 10% for ds, respectively. Conclusions: DECT in cardiac imaging is instrumental in assessing septal vein frequency. The 70% phase is optimal for MLC, while the 60% phase is preferred for TIRA.

show abstract

“…In addition, some studies that attempt to approach the ventricular septum through the septal perforator vein are introduced [ 6 , 7 ]. A study had examined the trans-coronary intraseptal RF ablation technique in the treatment of HOCM [ 8 ], which had shown that the utilization of the Thru-Septal RF ablation was eligible for evaluation in a clinical trial. However, Thru-Septal technologies are dependent on the septal perforator vein anatomy in approaching the basal interventricular septum (IVS) from the distal part of the coronary sinus.…”

Section: Introductionmentioning

confidence: 99%

The Cobra Catheter: A Novel Concept and Device for the Thru-Septal Myocardium Approach

Chon

Shin

Jung³

et al. 2022

Journal of Interventional Cardiology

Self Cite

View full text Add to dashboard Cite

Objectives. In our previous study, we suggested the novel septal traversing technique as effective and safe in catheter-based approach for septal myocardium. However, it is limited by its dependence on the septal perforator vein. This study aimed to evaluate the Cobra catheter as a backup catheter to overcome this limitation in swine. Methods. We designed the guiding Cobra catheter. It consisted of three major parts (the external pull-wire steerable distal tip, the C-shaped shaft, and the steering adjustment handle). We tested the difference in force between the guidewire passing through the muscle and the vessel wall using a push-pull gauge. We performed a septal wire engage procedure in swine using the Cobra catheter. The guidewire engagement of the septal vein and Cobra catheter were compared visually and histopathologically. Results. A total of ten swine were enrolled in this study. The success rate was 100% under fluoroscopy. The experiments confirmed the medical potential of the septal approach even in a location irrelevant to the septal perforator vein anatomy and confirmed that the wire passed well in the target direction in the harvested heart. There was no serious physical damage or pathological abnormalities in the vessel wall and myocardium. Conclusion. These results showed that the novel Cobra catheter with a septal vein-independent trans-septal approach may be a safe and effective alternative for the treatment of structural heart diseases.

show abstract

Septal Reduction Using Transvenous Intramyocardial Cerclage Radiofrequency Ablation

Abstract: Visual Abstract

Cited by 8 publications

References 26 publications

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

Cardiac Computed Tomography Identification of the Septal Vein—A Small Retrospective Study

The Cobra Catheter: A Novel Concept and Device for the Thru-Septal Myocardium Approach

Contact Info

Product

Resources

About