Endocardial hypothermia and pulmonary vein isolation with epicardial cryoablation in a porcine beating-heart model Saqib Masroor, MD, MHS, Mary-Ellen.

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Presentation transcript:

Endocardial hypothermia and pulmonary vein isolation with epicardial cryoablation in a porcine beating-heart model Saqib Masroor, MD, MHS, Mary-Ellen Jahnke, RN, Antoine Carlisle, DVM, Catherine Cartier, BSc, MEng, Jean-Pierre LaLonde, BSME, Timothy MacNeil, BS, Andre Tremblay, BSME, Fred Clubb, DVM, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 135, Issue 6, Pages 1327-1333.e5 (June 2008) DOI: 10.1016/j.jtcvs.2007.12.038 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A scatter plot depicting the lowest temperatures reached during epicardial cryoablation of right ventricular myocardium of varying thickness. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A typical dose-response curve of right ventricular endocardial temperature during 5-minute epicardial cryoablation. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A typical dose-response curve of left atrial endocardial temperature during 5-minute epicardial cryoablation. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A cartoon depicting the possible position of the thermocouple in relation to the tip of the cryoprobe during epicardial cryoablation of the right ventricle (A) versus the left atrium (B; see text). PVI, pulmonary vein isolation. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

A, Surgifrost XL probe. B, Close-up view of the ablating segment with a fixed sheath covering the outer 270° circumference. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Chromel-constantan thermocouple attached to a horizontally oriented steel wire, which prevents it from slipping out of the heart. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Linear cryoablation over the right ventricle Linear cryoablation over the right ventricle. Thermocouples are seen exiting under the cryoprobe. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Epicardial cryoablation in progress with the Surgifrost XL probe tightened around all 4 pulmonary veins. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Masson trichrome staining showing a transmural lesion. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 1327-1333.e5DOI: (10.1016/j.jtcvs.2007.12.038) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions