Myocardial Thermal Ablation with a Transesophageal High-Intensity Focused Ultrasound Probe: Experiments on Beating Heart Models.
Described here is a study of transesophageal thermal ablation of isolated and perfused beating hearts and non-human primates. An endoscope integrating a transesophageal echocardiography probe and a high-intensity focused ultrasound transducer was built and tested on five Langendorff-isolated hearts and three 30-kg baboons. B-Mode ultrasound, passive elastography and magnetic resonance imaging were performed to monitor thermal lesions. In isolated hearts, continuous and gated sonication parameters were evaluated with acoustic intensities of 9-12 W/cm2. Sonication parameters of gated exposures with 12 W/cm2 acoustic intensity for 5 min consistently produced visible lesions in the ventricles of isolated hearts. In animals, left atria and ventricles were exposed to repeated continuous sonications (4-15 times for 16 s) at an acoustic intensity at the surface of the transducer of 9 W/cm2. Clinical states of the baboons during and after the treatment were good. One suspected lesion in the left ventricle could be evidenced by elastography, but was not confirmed by magnetic resonance imaging. The transesophageal procedure therefore has the potential to create thermal lesions in beating hearts and its safety in clinical practice seems promising. However, further technical exploration of the energy deposition in the target would be necessary before the next pre-clinical experiments.
['Greillier|Paul|P|', 'Ankou|Bénédicte|B|', 'Bour|Pierre|P|', 'Zorgani|Ali|A|', 'Abell|Emma|E|', 'Lacoste|Romain|R|', 'Bessière|Francis|F|', 'Pernot|Mathieu|M|', 'Catheline|Stefan|S|', 'Quesson|Bruno|B|', 'Chevalier|Philippe|P|', 'Lafon|Cyril|C|']
D000818:Animals D006348:Cardiac Surgical Procedures D017548:Echocardiography, Transesophageal D054459:Elasticity Imaging Techniques D004867:Equipment Design D006321:Heart D057086:High-Intensity Focused Ultrasound Ablation D008279:Magnetic Resonance Imaging D008297:Male D023421:Models, Animal D048530:Papio anubis D015203:Reproducibility of Results D014159:Transducers
Ablation High-intensity focused ultrasound Baboons Passive Elastography Magnetic resonance imaging Cardiac arrhythmia Langendorff heart Minimally invasive ablation strategy Transesophageal ablation