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Preclinical safety testing of percutaneous transatrial access to the normal pericardial space for local cardiac drug delivery and diagnostic sampling
Author(s) -
Waxman Sergio,
Pulerwitz Todd C.,
Rowe Katharine A.,
Quist William C.,
Verrier Richard L.
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(200004)49:4<472::aid-ccd28>3.0.co;2-y
Subject(s) - medicine , pericardial fluid , percutaneous , pericardial effusion , pericarditis , catheter , thrombus , cardiology , surgery , radiology
Abstract The safety of a percutaneous method and streamlined catheter system to access the normal pericardial space via the right atrial appendage for drug delivery and diagnostic sampling was demonstrated in 20 anesthetized pigs. Access was successfully accomplished in all animals within 3 min of guide catheter positioning and was documented by fluoroscopic imaging and pericardial fluid sampling. The animals were sacrificed at 24 hr (n = 10) and 2 weeks (n = 10) for histopathologic analysis. Mean pericardial hematocrit was 1.1% ± 0.3% at initial sampling, 4.3% ± 1.4% at 24 hr ( P = 0.005 vs. baseline), and 0.4% ± 0.2% at 2 weeks ( P = 0.13 vs. baseline). At 24 hr, there was local inflammatory reaction in the atrial wall and a small thrombus at the site of puncture. At 2 weeks, no significant inflammatory changes or pericarditis were evident. The technique is well tolerated with no apparent adverse complications. Advances in intrapericardial therapeutics and diagnostics will direct the clinical application of this novel approach in human subjects. Cathet. Cardiovasc. Intervent. 49:472–477, 2000. © 2000 Wiley‐Liss, Inc.