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Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome
Author(s) -
Schuger Claudio D.,
Steinman Russell T.,
Lehmann Michael H.,
Schuger Lucia,
Boldea Deborah,
McMath Linda,
Spears J. Richard
Publication year - 1990
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1900100206
Subject(s) - medicine , ablation , coronary sinus , balloon , percutaneous , balloon catheter , sinus (botany) , cardiology , lumen (anatomy) , surgery , radiology , botany , biology , genus
Transcatheter direct current electrical shocks for ablation of left‐sided accessory pathways in Wolff‐Parkinson‐White patients have led to serious complications. We report the feasibility of percutaneous transcatheter laser balloon ablation of left‐sided accessory pathways from the coronary sinus using a 1,064‐nm, continuous wave Nd:YAG laser triple lumen catheter with an optical fiber terminating in a cylindrical diffusing tip within a 2‐cm‐long, 3‐mm‐diameter balloon transparent to Nd:YAG laser radiation. In eight mongrel dogs (18 to 31 kg), the laser balloon catheter was positioned via an 8 French guide catheter in the distal and proximal coronary sinus. During balloon inflation, two to three consecutive laser doses of 30 W × 20 sec were applied to each site (cumulative energy, 1,200 to 1,800 J). Coronary angiog‐raphy, left ventriculography, and coronary sinus injection were performed before and after laser exposure. After percutaneous transcatheter laser balloon ablation, there was no evidence of mitral regurgitation, left circumflex artery, coronary sinus obstruction, or perforation. Coagulation necrosis and/or polymor‐phonuclear infiltrates involving the atrioventricular groove and left atrial wall over a mean length of 17 mm were present in all eight dogs sacrificed 6 ± 1 hr postablation. In conclusion, percutaneous transcatheter laser balloon ablation from the coronary sinus is free of immediate major complications and may be feasible for potential interruption of left‐sided accessory pathways.