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Cardioscopically Guided Beating Heart Surgery: Paravalvular Leak Repair
Benoit Rosa1, Zurab Machaidze1, Margherita Mencattelli1
1Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts.
The Annals of Thoracic Surgery
|August 26, 2017
Summary
A novel cardioscope provides direct visualization for beating-heart intracardiac procedures, successfully localizing and aiding closure of aortic paravalvular leaks (PVLs) in a porcine model.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Interventional Cardiology
Background:
- Direct visualization techniques for beating-heart intracardiac procedures are limited.
- Aortic paravalvular leaks (PVLs) present a challenge for current visualization methods.
Purpose of the Study:
- To evaluate a novel cardioscope for localizing and closing aortic PVLs.
- To assess the feasibility of cardioscopy-guided intracardiac interventions.
Main Methods:
- A porcine model with a custom bioprosthetic aortic valve was used to create PVLs.
- Transapical delivery of occlusion devices was guided solely by cardioscopy.
- Echocardiography, morphologic evaluation, and procedure time assessed outcomes.
Main Results:
- Cardioscopy enabled PVL localization by visualizing regurgitant jet flow.
- Occluders were successfully placed in 84.6% of attempts (11/13).
- Successful device retrieval occurred in 50% of attempts (3/6).
Conclusions:
- Cardioscopy facilitates intracardiac interventions through direct visualization.
- This technology shows promise for beating-heart procedures like PVL closure.
