Safety and efficacy of pericardial endoscopy by percutaneous subxyphoid approach in swine heart in vivo

Takehiro Kimura, Shunichiro Miyoshi, Seiji Takatsuki, Kojiro Tanimoto, Kotaro Fukumoto, Kyoko Soejima, Keiichi Fukuda

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: A nonsurgical approach from the epicardial surface is useful for various cardiac interventions, such as positioning of the left ventricular lead for cardiac resynchronization therapy and epicardial ablation. Stem cell delivery on the epicardial surface can be considered in the future if good quality of visualization can be obtained. However, because the pericardial space is limited, hemodynamic conditions may deteriorate with pericardial endoscopy. Therefore, the feasibility and efficacy of pericardial endoscopy were examined by using ready-made endoscopes. Methods: Anesthetized swines (26-61 kg; n = 6) were used for the experiment. Electrocardiogram, femoral artery blood pressure, and oxygen saturation by pulse oximetry were continuously monitored during the procedures. Guided by the fluoroscopy, sheaths were advanced to the pericardial space using the modified Seldinger technique from the subxyphoid space. Results: After insertion of an endoscope with a maximum diameter of 6.9 mm, hemodynamic parameters were stable during the procedure with atropine. Stable and acceptable endoscopic images were obtained. Minor operations can be performed with pericardial endoscopic-guided laparoscopic forceps with no complications. Conclusions: The endoscopic pericardial procedure is effective and feasible. This procedure can increase the possibility and efficacy of nonsurgical treatment for cardiac diseases.

Original languageEnglish
Pages (from-to)181-190
Number of pages10
JournalJournal of Thoracic and Cardiovascular Surgery
Volume142
Issue number1
DOIs
Publication statusPublished - 2011 Jul

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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