Radiofrequency perforation and conventional needle percutaneous transseptal left heart access: pathological features
| Autor: | Marvin Estrada, Gruschen R. Veldtman, Lee N. Benson, Amanda Hartley, Gregory J. Wilson, Gunnar Norgard, Alejandro Peirone, Naheed Visram, Ramsey Leung |
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| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Percutaneous Necrosis Swine medicine.medical_treatment Perforation (oil well) Catheter ablation Punctures Muscle Smooth Vascular Lesion Heart Septum Medicine Animals Radiology Nuclear Medicine and imaging Myocytes Cardiac Heart Atria Aorta Cardiac catheterization business.industry Myocardium Models Cardiovascular Contraction band necrosis General Medicine Catheter Disease Models Animal Needles Catheter Ablation Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 65(4) |
| ISSN: | 1522-1946 |
| Popis: | Perforating radiofrequency (PRF) energy has been used to obtain percutaneous transseptal left heart access. Contrary to ablative radiofrequency (RF), myocardial tissue responses to PRF thermal injury are incompletely defined. In this study, a newly developed RF catheter system for transseptal left atrial entry was compared with conventional needle puncture. Of 15 piglets having transfemoral cardiac catheterization, 12 had transseptal procedures. Needle punctures (NP) and PRF were followed by acute (1 hr; 3 NP, 3 PRF) and chronic necropsy (1 month; 3 NP, 3 PRF). The remaining three piglets had intentional RF aortic perforation through the atrial roof with necropsy at 1 month. Gross and histopathological effects were examined. Acutely, the gross RF lesion was similar to needle puncture. Histologically, the RF lesions had minimal mural thrombus, an inner zone of thermal injury characterized by grayish cytoplasmic staining (elastic trichrome), and a bubbly transformation of the cytoplasm in innermost cardiomyocytes, partial persistence of cross-striations, and an acute inflammatory reaction. The outer extent of the lesion (< 1 mm) was defined by a halo of contraction band necrosis similar to needle puncture. Acute NP injury showed comparable depth and extent of myocyte necrosis (principally contraction bands) with adjacent tissue hemorrhage and edema. At 1 month, a well-developed densely collagenous scar was present in both aortic and transseptal PRF lesions. The extent of acute RF injury is similar to that seen in conventional NP, but the characteristics of tissue insult are different. Both show well-developed healing at 1 month. |
| Databáze: | OpenAIRE |
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