The effectiveness of rigid pericardial endoscopy for minimally invasive minor surgeries: cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation

Journal of Cardiothoracic Surgery

Keiichi Fukuda²  Seiji Takatsuki²  Kyoko Soejima³  Kojiro Tanimoto²  Kotaro Fukumoto²  Kazuma Okamoto¹  Shunichiro Miyoshi²  Takehiro Kimura² 

[1] Department of Cardiovascular surgery, Keio University School of Medicine, Tokyo, Japan;Department of Cardiology, Keio University School of Medicine, Tokyo, Japan;Department of Cardiology, Kyorin University Hospital, Tokyo, Japan

关键词: Epicardial ablation;    Epicardial pacemaker lead implantation;    Cell transplantation;    Minimally invasive surgery;    Rigid pericardial endoscopy;   

Others  :  1152581
DOI  :  10.1186/1749-8090-7-117

 received in 2012-03-30, accepted in 2012-11-03,  发布年份 2012

【 摘 要 】

Background

The efficacy and safety of rigid pericardial endoscopy as the promising minimally invasive approach to the pericardial space was evaluated. Techniques for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were developed.

Methods

Two swine and 5 canines were studied to evaluate the safety and efficacy of rigid pericardial endoscopy. After a double pericardiocentesis, a transurethral rigid endoscope was inserted into the pericardial space. The technique to obtain a clear visual field was examined, and acute complications such as hemodynamic changes and the effects on intra-pericardial pressure were evaluated. Using custom-made needles, pacemaker leads, and forceps, the applications for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were also evaluated.

Results

The use of air, the detention of a stiff guide wire in the pericardial space, and the stretching of the pericardium with the rigid endoscope were all useful to obtain a clear visual field. A side-lying position also aided observation of the posterior side of the heart. As a cell transplantation methodology, we developed an ultrasonography-guided needle, which allows for the safe visualization of transplantation without major complications. Pacemaker leads were safely and properly implanted, which provides a better outcome for cardiac resynchronizing therapy. Furthermore, the success of clear visualization of the pulmonary veins enabled us to perform epicardial ablation.

Conclusions

Rigid pericardial endoscopy holds promise as a safe method for minimally invasive cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation by allowing clear visualization of the pericardial space.

【 授权许可】

   
2012 Kimura et al.; licensee BioMed Central Ltd.

【 图 表 】

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