Document Detail


Transapical beating heart cardioscopy technique for off-pump visualization of heart valves.
MedLine Citation:
PMID:  22341423     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Endoscopic methods to perform intracardiac procedures are of enormous interest, with the introduction of transcatheter techniques for complex cardiac procedures. In the present study, we demonstrate the use of a novel transapical cardioscopy system to visualize intracardiac structures in a porcine model. METHODS: The cardioscope was designed to mount a miniature CCD camera at its tip and was covered in a blunt convex Plexiglass top that allowed displacement and visualization of the tissue in front of the cardioscope. Transapical access for 11-mm cardioscopy was performed by way of a median sternotomy (n = 4) and minithoracotomy (n = 1) in an anesthetized porcine model, and various cardiac structures were imaged under beating heart conditions. The images from the camera were projected onto a monitor for the operator to guide cardioscope positioning. RESULTS: Video images and identification of structures on the left side of an in vivo beating porcine heart were obtained. Initially, the papillary muscle and mitral valve components were evaluated. The left atrium was entered, and the pulmonary vein orifices and atrial appendage were confirmed. Next, the camera was positioned within the left ventricle, and the ventricular portion of the trileaflet aortic valve was inspected. Using direct visualization, the camera was passed into the proximal ascending aorta. The left and right coronary arteries were also visualized. A catheter was introduced by way of a side port to confirm the position of the aortic valve leaflets during visualization. The pig experienced no significant decrease in blood pressure and maintained a stable heart rate throughout the procedure. The port was removed, and the transapical incision was closed with minimal blood loss during the procedure and closure of the orifice. CONCLUSIONS: Transapical cardioscopy is a novel approach that allows for precise visualization of intracardiac structures within a beating porcine heart without the use of cardiopulmonary bypass. This technique might allow for more successful minimally invasive valvular, intracardiac, or ascending aortic procedures without the use of radiation.
Authors:
Muralidhar Padala; Jorge H Jimenez; Ajit P Yoganathan; Albert Chin; Vinod H Thourani
Related Documents :
25189213 - Heart failure, saxagliptin and diabetes mellitus: observations from the savor - timi 53...
25278973 - Hypoxia training attenuates left ventricular remodeling in rabbit with myocardial infar...
8055563 - Directional coronary atherectomy can be successfully performed in the elderly.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-14
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  -     ISSN:  1097-685X     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Asymmetric septal hypertrophy in patients with severe aortic stenosis: The usefulness of associated ...
Next Document:  Prospective study of endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes...