Document Detail


Therapeutic ultrasound to noninvasively create intracardiac communications in an intact animal model.
MedLine Citation:
PMID:  20853366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if pulsed cavitational ultrasound therapy (histotripsy) can accurately and safely generate ventricular septal defects (VSDs) through the intact chest of a neonatal animal, with the eventual goal of developing a noninvasive technique of creating intra-cardiac communications in patients with congenital heart disease.
BACKGROUND: Histotripsy is an innovative ultrasonic technique that generates demarcated, mechanical tissue fractionation utilizing high intensity ultrasound pulses. Previous work has shown that histotripsy can create atrial septal defects in a beating heart in an open-chest canine model.
METHODS: Nine neonatal pigs were treated with transcutaneous histotripsy targeting the ventricular septum. Ultrasound pulses of 5-μsec duration at a peak negative pressure of 13 MPa and a pulse repetition frequency of 1 kHz were generated by a 1 MHz focused transducer. The procedure was guided by real-time ultrasound imaging.
RESULTS: VSDs were created in all pigs with diameters ranging from 2 to 6.5 mm. Six pigs were euthanized within 2 hrs of treatment, while three were recovered and maintained for 2-3 days to evaluate lesion maturation and clinical side effects. There were only transient clinical effects and pathology revealed mild collateral damage around the VSD with no significant damage to other cardiac or extra-cardiac structures.
CONCLUSIONS: Histotripsy can accurately and safely generate VSDs through the intact chest in a neonatal animal model. These results suggest that with further advances, histotripsy can be a useful, noninvasive technique to create intracardiac communications, which currently require invasive catheter-based or surgical procedures, to clinically stabilize newborn infants with complex congenital heart disease.
Authors:
Gabe E Owens; Ryan M Miller; Greg Ensing; Kimberly Ives; David Gordon; Achi Ludomirsky; Zhen Xu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-12
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-25     Completed Date:  2011-06-10     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  580-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Disease Models, Animal*
Echocardiography, Doppler, Color
Equipment Design
Heart Septal Defects, Ventricular / etiology*,  pathology,  ultrasonography
Microbubbles
Swine
Time Factors
Transducers
Ultrasonic Therapy / adverse effects*,  instrumentation
Ultrasonography, Interventional
Grant Support
ID/Acronym/Agency:
R01 HL077629/HL/NHLBI NIH HHS; R01 HL077629/HL/NHLBI NIH HHS; R01 HL077629-04/HL/NHLBI NIH HHS
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