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Published on: February 18, 2020
The Cobra Catheter: A Novel Concept and Device for the Thru-Septal Myocardium Approach
Min-Ku Chon1, Dong-Hoon Shin2, Su-Jin Jung3
1Department of Cardiology, School of Medicine, Pusan National University and Cardiovascular Center, Yangsan Hospital, Yangsan (50612), Republic of Korea.
Insights
A novel Cobra catheter enables septal vein-independent trans-septal approaches for structural heart disease treatment. This safe and effective method overcomes previous limitations, offering a new option for cardiac interventions.
Area of Science:
- Cardiovascular Interventions
- Medical Device Design
- Animal Models in Research
Background:
- Previous septal myocardium catheterization relied on septal perforator veins.
- This dependence limited the applicability of the septal traversing technique.
- A backup catheter was needed to overcome anatomical limitations.
Purpose of the Study:
- To evaluate the Cobra catheter as a backup for septal vein-independent trans-septal approaches.
- To assess the safety and efficacy of this novel technique in swine.
- To overcome limitations of previous catheter-based septal interventions.
Main Methods:
- A guiding Cobra catheter was designed with a steerable tip, C-shaped shaft, and steering handle.
- Force testing was performed using a push-pull gauge.
- Septal wire engagement was conducted in swine, with visual and histopathological comparisons.
Main Results:
- The Cobra catheter achieved a 100% success rate in swine under fluoroscopy.
- The septal approach proved effective independent of septal perforator vein anatomy.
- No significant damage to the vessel wall or myocardium was observed.
Conclusions:
- The Cobra catheter facilitates a safe and effective septal vein-independent trans-septal approach.
- This technique offers a promising alternative for treating structural heart diseases.
- The findings support the clinical potential of this novel catheter system.
Objectives:
In our previous study, we suggested the novel septal traversing technique as effective and safe in catheter-based approach for septal myocardium. However, it is limited by its dependence on the septal perforator vein. This study aimed to evaluate the Cobra catheter as a backup catheter to overcome this limitation in swine.
Methods:
We designed the guiding Cobra catheter. It consisted of three major parts (the external pull-wire steerable distal tip, the C-shaped shaft, and the steering adjustment handle). We tested the difference in force between the guidewire passing through the muscle and the vessel wall using a push-pull gauge. We performed a septal wire engage procedure in swine using the Cobra catheter. The guidewire engagement of the septal vein and Cobra catheter were compared visually and histopathologically.
Results:
A total of ten swine were enrolled in this study. The success rate was 100% under fluoroscopy. The experiments confirmed the medical potential of the septal approach even in a location irrelevant to the septal perforator vein anatomy and confirmed that the wire passed well in the target direction in the harvested heart. There was no serious physical damage or pathological abnormalities in the vessel wall and myocardium.
Conclusion:
These results showed that the novel Cobra catheter with a septal vein-independent trans-septal approach may be a safe and effective alternative for the treatment of structural heart diseases.
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