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      Temperature-Controlled High Frequency Ablation for Creation of Transmyocardial Channels: In vivo Validation of a Novel Method

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          Abstract

          Objective: We investigated the feasibility and short-term effects of a novel procedure to create intramyocardial channels by means of high frequency (HF) ablation in a rabbit in vivo model. Methods: A flexible catheter ending in a cylindrical electrode (diameter 0.7 mm) with a sharpened tip was used for HF energy application following transmyocardial insertion. Power-controlled or energy-controlled energy applications were performed in 16 anesthetized rabbits after thoracotomy with a follow-up for 3 h. Assessment of myocardial channels and the necrotic zone was performed by morphometric quantification in serial sections. The ferret diameter was used to compare channel dimensions and the extent of necrosis. Results: Thirty-nine power-controlled and 54 temperature-controlled HF applications were performed. The shape of identified channels was round in 71% and 69% had a lumen patency of ≥2/3 of the channel. Ferret diameter of the channels was 414 ± 180 μm and of the necrotic zone 3,558 ± 1,200 μm. In temperature-controlled applications, channel dimensions were strongly influenced by the maximum tissue temperature and the duration of energy delivery (T<sub>max</sub>: p = 0.0006; duration: p = 0.003). Channel and necrosis dimensions correlated better with biometric parameters in temperature-controlled compared with power-controlled applications. Conclusion: Mechanically created transmyocardial channels can be stabilized by HF heating of the surrounding tissue. A high percentage of these channels remain patent. The channel dimensions are closely correlated with maximum temperature and duration of energy delivery in a temperature-controlled application mode.

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          Most cited references 3

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          Histologic appearance of transmyocardial laser channels after 4 1/2 weeks.

          Preliminary results of clinical studies suggest that transmyocardial laser revascularization is an effective treatment for patients with chronic angina that cannot be treated by other means. The mechanism of this effect remains controversial. We present autopsy results from a patient obtained 4 1/2 weeks after operation that show that the channels do not maintain patency. Further work is needed to determine the frequency of channel patency and its relation to clinical benefit.
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            Physiology, histology, and 2-week morphology of acute transmyocardial channels made with a CO2 laser

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              • Abstract: not found
              • Article: not found

              End stage coronary disease treated with the transmyocardial CO2 laser revascularisation: a chance for the 'inoperable' patient

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2000
                September 2000
                02 October 2000
                : 93
                : 4
                : 234-241
                Affiliations
                aMedical Clinic II, bInstitute of Pathology and cInstitute for Medical Statistics and Documentation, University Hospital, Mainz, Germany; dMedtronic, Bakken Research Center, Maastricht, The Netherlands
                Article
                7032 Cardiology 2000;93:234–241
                10.1159/000007032
                11025349
                © 2000 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 6, References: 16, Pages: 8
                Categories
                General Cardiology – Basic Science

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