title: Transcatheter neodymium-yttrium-aluminum-garnet laser coagulation of canine ventricle using a balloon-tipped cardioscope.
abstract: The feasibility of transcatheter laser ablation of the canine left ventricle (LV) was tested using a newly developed cardioscope. In 17 anesthetized dogs, a combined laser-endoscope catheter, consisting of an endoscope encased in a 7-French flexible catheter with an inflatable and transparent balloon at the distal end, was introduced into the LV via the carotid artery. A 1064-nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser was delivered by laser optic fiber, which was introduced through the transport channel and positioned inside the saline-filled balloon. In 16 of 17 dogs, the endocardial surface of the LV was clearly observed. Laser energy totaling 500-5,000 J was applied sequentially in 13 dogs and laser irradiation was completed in all but 2 of the dogs. The excised hearts revealed well-demarcated oval-shaped lesions 2.5-9.5 mm deep in 7 of 11 dogs. Histologic sections revealed coagulation necrosis surrounded by a rim of contraction band necrosis. Thus, transballoon laser photocoagulation of the beating LV is feasible. The newly combined laser-endoscope catheter, which is still in its preliminary stages and needs to be improved to increase the success rate of photocoagulation, appears to be a promising alternative modality for catheter ablative therapy for ventricular tachycardia.
authors.affiliation: First Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hirao
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.forename: N
authors.initials: N
authors.lastname: Toshida
authors.forename: H
authors.initials: H
authors.lastname: Nawata
authors.forename: N
authors.initials: N
authors.lastname: Ishihara
authors.forename: F
authors.initials: F
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Miyasaka
authors.forename: K
authors.initials: K
authors.lastname: Hiejima
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000818:Animals; D017115:Catheter Ablation / Q000379:methods*; D004285:Dogs; D019723:Endoscopes; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000601:surgery*; D017075:Laser Coagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*