Radiofrequency perforation of the pulmonary valve: an efficient low cost solution
| Autor: | Marc Gewillig, Bjorn Cools, Stephen C. Brown, Derize Boshoff, Benedicte Eyskens, Ruth Heying |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Cost-Benefit Analysis medicine.medical_treatment 030204 cardiovascular system & hematology Coronary Angiography Cardiac Catheters 03 medical and health sciences 0302 clinical medicine Angioplasty medicine Humans Pericardium In patient 030212 general & internal medicine Pulmonary Valve business.industry Infant Newborn Infant Health Care Costs General Medicine medicine.disease Surgery Catheter Treatment Outcome medicine.anatomical_structure Pulmonary Atresia Pulmonary valve Catheter Ablation Feasibility Studies Female Stents Radiology Cardiology and Cardiovascular Medicine business Pulmonary atresia Angioplasty Balloon |
| Zdroj: | Acta Cardiologica. 72:419-424 |
| ISSN: | 0373-7934 0001-5385 |
| DOI: | 10.1080/00015385.2017.1335095 |
| Popis: | Objective The aim of the study was to assess the feasibility of using commonly available catheterization laboratory equipment for radiofrequency perforation of the pulmonary valve in patients with pulmonary atresia and intact ventricular septum. Methods The system (off-label use for all items) is made up of a co-axial telescopic arrangement consisting of a 0.014" PT 2 ™ coronary guidewire, for insulation inside a 2.7-F microcatheter which has an inner lumen of 0.021". The microcatheter was passed via a standard 4-F right coronary catheter to just below the atretic pulmonary valve. Radiofrequency (RF) energy was delivered using a standard electrosurgical system. In vitro testing had been performed and indicated that 5-10 W for 2-5 s would be sufficient for valve perforation. Results Radiofrequency perforation was successfully performed in all (n = 5, 100%) patients at a median age of 3 days (range: 1-36) and weight 2.7 kg (range 2.3-3.0). In one patient the pericardium was entered during the initial attempt; the generator was put on coagulation mode during retrieval of the guidewire and no haemopericardium occurred. The pulmonary valve was dilated in all; in three patients (n = 3) the ductus arteriosus was stented during the same session. Conclusion Results of the study show that it is feasible to perforate the pulmonary valve safely using this system. Availability, simplicity and cost are noteworthy benefits. |
| Databáze: | OpenAIRE |
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