Transcatheter Electrosurgery JACC State-of-the-Art Review

被引：53

作者：

Khan, Jaffar M. ^{[1
,2
]}

Rogers, Toby ^{[1
,2
]}

Greenbaum, Adam B. ^{[3
]}

Babaliaros, Vasilis C. ^{[3
]}

Yildirim, Dursun Korel ^{[1
]}

Bruce, Christopher G. ^{[1
]}

Herzka, Daniel A. ^{[1
]}

Schenke, William H. ^{[1
]}

Ratnayaka, Kanishka ^{[1
,4
]}

Lederman, Robert J. ^{[1
]}

机构：

[1] NHLBI, Cardiovasc Branch, Div Intramural Res, NIH, Bldg 10,Room 2C713,MSC 1538, Bethesda, MD 20892 USA

[2] Medstar Washington Hosp Ctr, Washington, DC USA

[3] Emory Univ Hosp, Struct Heart & Valve Ctr, 1364 Clifton Rd NE, Atlanta, GA 30322 USA

[4] UCSD Rady Childrens Hosp, San Diego, CA USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2020年 / 75卷 / 12期

基金：

美国国家卫生研究院;

关键词：

BASILICA; ELASTA-Clip; LAMPOON; transcatheter electrosurgery; transcaval; VENTRICULAR OUTFLOW TRACT; AORTIC-VALVE-REPLACEMENT; LEFT-HEART SYNDROME; RADIOFREQUENCY PERFORATION; PULMONARY-ATRESIA; TRANSCAVAL ACCESS; CORONARY OBSTRUCTION; TRANSSEPTAL NEEDLE; LACERATION; CREATION;

D O I：

10.1016/j.jacc.2020.01.035

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Transcatheter electrosurgery refers to a family of procedures using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood. The authors review theory, simulations, and benchtop demonstrations of how guidewires, insulation, adjunctive catheters, and dielectric medium interact. For tissue traversal, all but the tip of traversing guidewires is insulated to concentrate current. For leaflet laceration, the "Flying V" configuration concentrates current at the inner lacerating surface of a kinked guidewire. flooding the field with non-ionic dextrose eliminates alternative current paths. Clinical applications include traversing occlusions (pulmonary atresia, arterial and venous occlusion, and iatrogenic graft occlusion), traversing tissue planes (atrial and ventricular septat puncture, radiofrequency valve repair, transcaval access, Potts and Glenn shunts), and leaflet laceration (BASILICA, LAMPOON, ELASTA-Clip, and others). Tips are provided for optimizing these techniques. Transcatheter electrosurgery already enables a range of novel therapeutic procedures for structural heart disease, and represents a promising advance toward transcatheter surgery. Published by Elsevier on behalf of the American College of Cardiology Foundation.

引用

页码：1455 / 1470

页数：16

共 68 条

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