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Published on: May 18, 2021
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Pericardial Access Through the Right Atrium in a Porcine Model
Ishan Kamat1,2, William E Cohn3,2
1Department of Internal Medicine, Baylor College of Medicine, Houston, Texas.
Texas Heart Institute Journal
|April 29, 2021
Summary
A novel technique using carbon dioxide (CO2) insufflation safely improves pericardial access for cardiac procedures. This method enhances visualization and reduces risks associated with current approaches.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Interventional Cardiology
Background:
- Current pericardial access methods carry risks due to limited lubrication in the pericardial space.
- Increasingly common procedures like epicardial ablation and LAA occlusion necessitate safer access techniques.
Purpose of the Study:
- To develop and evaluate a novel, safer method for accessing the pericardial space.
- To utilize carbon dioxide (CO2) insufflation for improved visualization during pericardial access.
Main Methods:
- A new technique involving CO2 insufflation via right atrial puncture under fluoroscopic guidance was developed.
- The procedure was tested in 8 Landrace pigs, followed by conventional transthoracic pericardial access.
Main Results:
- All animals remained hemodynamically stable throughout the CO2 insufflation procedure.
- No evidence of epicardial or coronary injury was observed in the porcine model.
- CO2 insufflation facilitated clear visualization of the cardiac silhouette, separating it from the chest wall.
Conclusions:
- CO2 insufflation via right atrial puncture offers a potentially safer approach to pericardial access.
- This novel method demonstrates feasibility and safety in a porcine model, warranting further investigation for clinical application.
