Transcatheter Electrosurgery: JACC State-of-the-Art Review. [Review]

MedStar author(s):
Citation: Journal of the American College of Cardiology. 75(12):1455-1470, 2020 03 31.PMID: 32216915Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Electrosurgery/mt [Methods] | *Heart Valve Prosthesis Implantation/mt [Methods] | *Prosthesis Design/mt [Methods] | *Transcatheter Aortic Valve Replacement/mt [Methods] | Cardiology/mt [Methods] | Cardiology/td [Trends] | Electrosurgery/td [Trends] | Heart Valve Diseases/dg [Diagnostic Imaging] | Heart Valve Diseases/su [Surgery] | Heart Valve Prosthesis Implantation/td [Trends] | Humans | Prosthesis Design/td [Trends] | Review Literature as Topic | Transcatheter Aortic Valve Replacement/td [Trends]Year: 2020Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0735-1097
Name of journal: Journal of the American College of CardiologyAbstract: Transcatheter electrosurgery refers to a family of procedures using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood. The authors review theory, simulations, and benchtop demonstrations of how guidewires, insulation, adjunctive catheters, and dielectric medium interact. For tissue traversal, all but the tip of traversing guidewires is insulated to concentrate current. For leaflet laceration, the "Flying V" configuration concentrates current at the inner lacerating surface of a kinked guidewire. Flooding the field with non-ionic dextrose eliminates alternative current paths. Clinical applications include traversing occlusions (pulmonary atresia, arterial and venous occlusion, and iatrogenic graft occlusion), traversing tissue planes (atrial and ventricular septal puncture, radiofrequency valve repair, transcaval access, Potts and Glenn shunts), and leaflet laceration (BASILICA, LAMPOON, ELASTA-Clip, and others). Tips are provided for optimizing these techniques. Transcatheter electrosurgery already enables a range of novel therapeutic procedures for structural heart disease, and represents a promising advance toward transcatheter surgery. Copyright Published by Elsevier Inc.All authors: Babaliaros VC, Bruce CG, Greenbaum AB, Herzka DA, Khan JM, Lederman RJ, Ratnayaka K, Rogers T, Schenke WH, Yildirim DKOriginally published: Journal of the American College of Cardiology. 75(12):1455-1470, 2020 Mar 31.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 32216915 Available 32216915

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

Transcatheter electrosurgery refers to a family of procedures using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood. The authors review theory, simulations, and benchtop demonstrations of how guidewires, insulation, adjunctive catheters, and dielectric medium interact. For tissue traversal, all but the tip of traversing guidewires is insulated to concentrate current. For leaflet laceration, the "Flying V" configuration concentrates current at the inner lacerating surface of a kinked guidewire. Flooding the field with non-ionic dextrose eliminates alternative current paths. Clinical applications include traversing occlusions (pulmonary atresia, arterial and venous occlusion, and iatrogenic graft occlusion), traversing tissue planes (atrial and ventricular septal puncture, radiofrequency valve repair, transcaval access, Potts and Glenn shunts), and leaflet laceration (BASILICA, LAMPOON, ELASTA-Clip, and others). Tips are provided for optimizing these techniques. Transcatheter electrosurgery already enables a range of novel therapeutic procedures for structural heart disease, and represents a promising advance toward transcatheter surgery. Copyright Published by Elsevier Inc.

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