Transmyocardial Channeling

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Presentation transcript:

Transmyocardial Channeling Cliff Van Meter, Marvin J. Slepian, Jack G. Copeland Operative Techniques in Thoracic and Cardiovascular Surgery Volume 6, Issue 3, Pages 140-148 (August 2001) DOI: 10.1053/otct.2001.23224 Copyright © 2001 Elsevier Inc. Terms and Conditions

1 (A) Thermal and acoustic injury surrounding a TMR laser channel with creation of tissue debris. (B) A TMC created channel with aspiration of the tissue core and without surrounding tissue injury. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

2 Hand-held device with a malleable tip and a rotating hollow coring needle. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

3 Anterolateral thoracotomy with the flexible tip accessing the anterior left ventricular wall. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

4 Sternotomy and pericardial wall with device accessing posterolateral wall. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

5 Low-power view of the channel at 60 days. The channel is filled with fibrous tissue, and vessels are seen (arrow) traversing the scarred channel area. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

6 Intramyocardial channel filled with fibrosis tissue (blue), with vessels interspersed within the area of scarring. Note a muscular artery at the border zone of viable myocardium and the scar (arrow). Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions

7 Intramyocardial muscular artery within the healthy myocardium that has given rise to a smaller artery (arrow) infiltrating into the area of the channel, which is showing fibrosis. Operative Techniques in Thoracic and Cardiovascular Surgery 2001 6, 140-148DOI: (10.1053/otct.2001.23224) Copyright © 2001 Elsevier Inc. Terms and Conditions