| Transmural atrial fibrosis after epicardial and endocardial argon-powered CryoMaze ablation. | |
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MedLine Citation:
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PMID: 21395689 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The CryoMaze procedure is usually limited to endocardial ablation under cardio-pulmonary bypass. Epicardial ablation is considered inferior as endocardial islets of atrial tissue could theoretically remain viable, protected from cryoinjury by epicardial fat and endocardial circulating warm blood. Novel argon-powered cryoprobes with lower ablation temperatures have recently become available. It is unclear if these instruments can reliably induce transmural atrial fibrosis by epicardial cryoablation on the beating heart. METHODS: Ten sheep were divided into two equal groups. CryoMaze ablations were applied using an argon-powered cryoprobe with an ablation temperature of -185°C. In the control group, standardized ablations (n = 50) were applied endocardially under cardiopulmonary bypass. In the experimental group, corresponding ablations (n = 50) were applied epicardially on the beating heart. Postoperatively the animals were monitored for 30 days. At necropsy, the lesions were explanted and analyzed histologically for evidence of transmural fibrosis. RESULTS: Two animals in the control group and one animal in the experimental group died prematurely. Autopsy of the remaining animals showed that all lesions (n = 70) had retained their structural integrity. In the control group, histology demonstrated transmural fibrosis in 94% (28/30) of the endocardially applied lesions. In the experimental group, histology demonstrated transmural fibrosis in 95% (38/40) of the epicardially applied lesions. Statistical analysis revealed no significant difference between the two groups (p = 0.96). CONCLUSION: Argon-powered epicardial cryoablation on the beating heart is as efficient in inducing transmural fibrosis as the traditional technique of endocardial ablation under cardio-pulmonary bypass. |
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Authors:
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Robert P Gallegos; Andrew L Rivard; Taufiek K Rajab; B Chir; Jan D Schmitto; Matthew T Lahti; Nicole Kirchhof; Richard W Bianco |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 26 ISSN: 1540-8191 ISO Abbreviation: J Card Surg Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-14 Completed Date: 2011-07-26 Revised Date: 2011-08-10 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 240-3 Citation Subset: IM |
Copyright Information:
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© 2011 Wiley Periodicals, Inc. |
Affiliation:
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Experimental Surgical Services, University of Minnesota, Minneapolis, Minnesota, USA. rgallegos@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Atrial Fibrillation / surgery* Disease Models, Animal Endocardium / surgery* Fibrosis / etiology, pathology Heart Atria / pathology* Laser Therapy / adverse effects*, instrumentation Lasers, Excimer / adverse effects, therapeutic use* Myocardium / pathology* Postoperative Complications* Pulmonary Veins / surgery Sheep |
| Comments/Corrections | |
Erratum In:
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J Card Surg. 2011 May;26(3):341 Note: Chir, B [removed] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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