Chronic histological transmurality of high-intensity focused ultrasound ablation
Paolo Vanelli1, Roberta Rossi, Guido Gelpi
1Department of Cardiovascular Surgery, A.O. Polo Universitario Luigi Sacco, Milan, Italy. vanelli.paolo@hsacco.it
Insights
High-intensity focused ultrasound (HIFU) effectively creates transmural lesions in the left atrium for surgical maze procedures. Histologic analysis confirms HIFU as an acceptable energy source for atrial ablation.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Histopathology
Background:
- Surgical maze procedures aim to treat cardiac arrhythmias.
- Evaluating novel energy sources for creating effective atrial lesions is crucial.
Observation:
- Histologic examination of tissue specimens from two patients 6 and 48 months post-procedure.
- Specimens were obtained from the mitral isthmus and pulmonary vein area ('box lesion').
Findings:
- Complete transmural lesions were consistently observed.
- Chronic lesions showed connective tissue replacement of muscle.
- Atrial wall thickness and vascularization remained normal post-ablation.
Implications:
- High-intensity focused ultrasound (HIFU) is a viable energy source for creating transmural atrial lesions.
- HIFU ablation demonstrates safety and efficacy in human left atrium during beating conditions.
- This supports HIFU as a potential tool in surgical arrhythmia management.
Abstract:
We evaluated histologic results for surgical left maze with an high-intensity focused ultrasound (HIFU) energy source. Two patients came to our attention 6 and 48 months, respectively, after ablation concomitant to a valve procedure. Tissue specimens, obtained from the lesion site on the mitral isthmus and from the "box lesion" around the pulmonary veins were analyzed histologically. A complete transmural lesion was found in all specimens. Chronic lesions exhibited replacement of the muscular band with connective tissue. The atrial wall maintained normal thickness and vascularization. HIFU ablation represents an acceptable energy source to create transmural lesions on the beating human left atrium.
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