Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome
Identifieur interne : 000A66 ( Main/Corpus ); précédent : 000A65; suivant : 000A67Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome
Auteurs : Schuger ; Russell T. Steinman ; Michael H. Lehmann ; Lucia Schuger ; Deborah Boldea ; Linda Mcmath ; J. Richard SpearsSource :
- Lasers in Surgery and Medicine [ 0196-8092 ] ; 1990.
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- KwdEn :
Abstract
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.
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DOI: 10.1002/lsm.1900100206
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Lehmann</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Schuger, Lucia" sort="Schuger, Lucia" uniqKey="Schuger L" first="Lucia" last="Schuger">Lucia Schuger</name><affiliation><mods:affiliation>Department of Pathology, University of Michigan, Ann Arbor</mods:affiliation></affiliation></author><author><name sortKey="Boldea, Deborah" sort="Boldea, Deborah" uniqKey="Boldea D" first="Deborah" last="Boldea">Deborah Boldea</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Mcmath, Linda" sort="Mcmath, Linda" uniqKey="Mcmath L" first="Linda" last="Mcmath">Linda Mcmath</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Spears, J Richard" sort="Spears, J Richard" uniqKey="Spears J" first="J. 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Lehmann</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Schuger, Lucia" sort="Schuger, Lucia" uniqKey="Schuger L" first="Lucia" last="Schuger">Lucia Schuger</name><affiliation><mods:affiliation>Department of Pathology, University of Michigan, Ann Arbor</mods:affiliation></affiliation></author><author><name sortKey="Boldea, Deborah" sort="Boldea, Deborah" uniqKey="Boldea D" first="Deborah" last="Boldea">Deborah Boldea</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Mcmath, Linda" sort="Mcmath, Linda" uniqKey="Mcmath L" first="Linda" last="Mcmath">Linda Mcmath</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author><author><name sortKey="Spears, J Richard" sort="Spears, J Richard" uniqKey="Spears J" first="J. Richard" last="Spears">J. Richard Spears</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Lasers in Surgery and Medicine</title><title level="j" type="abbrev">Lasers Surg. Med.</title><idno type="ISSN">0196-8092</idno><idno type="eISSN">1096-9101</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="1990">1990</date><biblScope unit="volume">10</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="140">140</biblScope><biblScope unit="page" to="148">148</biblScope></imprint><idno type="ISSN">0196-8092</idno></series><idno type="istex">8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB</idno><idno type="DOI">10.1002/lsm.1900100206</idno><idno type="ArticleID">LSM1900100206</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0196-8092</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Nd</term><term>YAG laser</term><term>accessory pathways</term><term>angiography</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Dr. Schuger MD</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item><json:item><name>Russell T. Steinman MD</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item><json:item><name>Michael H. Lehmann MD</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item><json:item><name>Lucia Schuger MD</name><affiliations><json:string>Department of Pathology, University of Michigan, Ann Arbor</json:string></affiliations></json:item><json:item><name>Deborah Boldea BS</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item><json:item><name>Linda McMath MS</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item><json:item><name>J. Richard Spears MD</name><affiliations><json:string>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>accessory pathways</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Nd</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>YAG laser</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>angiography</value></json:item></subject><articleId><json:string>LSM1900100206</json:string></articleId><language><json:string>eng</json:string></language><abstract>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.</abstract><qualityIndicators><score>6.831</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1527</abstractCharCount><pdfWordCount>4239</pdfWordCount><pdfCharCount>26573</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>216</abstractWordCount></qualityIndicators><title>Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome</title><genre><json:string>article</json:string></genre><host><volume>10</volume><publisherId><json:string>LSM</json:string></publisherId><pages><total>9</total><last>148</last><first>140</first></pages><issn><json:string>0196-8092</json:string></issn><issue>2</issue><subject><json:item><value>Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1096-9101</json:string></eissn><title>Lasers in Surgery and Medicine</title><doi><json:string>10.1002/(ISSN)1096-9101</json:string></doi></host><publicationDate>1990</publicationDate><copyrightDate>1990</copyrightDate><doi><json:string>10.1002/lsm.1900100206</json:string></doi><id>8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><availability><p>WILEY</p></availability><date>1990</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome</title><author><persName><surname>Schuger</surname></persName><roleName type="degree">Dr.</roleName><note type="correspondence"><p>Correspondence: Division of Cardiology Harper Hospital 3990 John R., Detroit, MI 48201</p></note><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author><author><persName><forename type="first">Russell T.</forename><surname>Steinman</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author><author><persName><forename type="first">Michael H.</forename><surname>Lehmann</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author><author><persName><forename type="first">Lucia</forename><surname>Schuger</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Pathology, University of Michigan, Ann Arbor</affiliation></author><author><persName><forename type="first">Deborah</forename><surname>Boldea</surname></persName><roleName type="degree">BS</roleName><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author><author><persName><forename type="first">Linda</forename><surname>McMath</surname></persName><roleName type="degree">MS</roleName><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author><author><persName><forename type="first">J. Richard</forename><surname>Spears</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation></author></analytic><monogr><title level="j">Lasers in Surgery and Medicine</title><title level="j" type="abbrev">Lasers Surg. Med.</title><idno type="pISSN">0196-8092</idno><idno type="eISSN">1096-9101</idno><idno type="DOI">10.1002/(ISSN)1096-9101</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="1990"></date><biblScope unit="volume">10</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="140">140</biblScope><biblScope unit="page" to="148">148</biblScope></imprint></monogr><idno type="istex">8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB</idno><idno type="DOI">10.1002/lsm.1900100206</idno><idno type="ArticleID">LSM1900100206</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1990</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>accessory pathways</term></item><item><term>Nd</term></item><item><term>YAG laser</term></item><item><term>angiography</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1989-12-14">Registration</change><change when="1990">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Inc.</publisherName><publisherLoc>New York</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1096-9101</doi><issn type="print">0196-8092</issn><issn type="electronic">1096-9101</issn><idGroup><id type="product" value="LSM"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="LASERS IN SURGERY AND MEDICINE">Lasers in Surgery and Medicine</title><title type="short">Lasers Surg. 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Richard</givenNames><familyName>Spears</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Pathology, University of Michigan, Ann Arbor</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">accessory pathways</keyword><keyword xml:id="kwd2">Nd</keyword><keyword xml:id="kwd3">YAG laser</keyword><keyword xml:id="kwd4">angiography</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Percutaneous Transcatheter Laser Balloon Ablation</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Percutaneous transcatheter laser balloon ablation from the canine coronary sinus: Implications for the Wolff‐Parkinson‐White syndrome</title></titleInfo><name type="personal"><namePart type="termsOfAddress">Dr.</namePart><namePart type="family">Schuger</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><description>Correspondence: Division of Cardiology Harper Hospital 3990 John R., Detroit, MI 48201</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Russell T.</namePart><namePart type="family">Steinman</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael H.</namePart><namePart type="family">Lehmann</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lucia</namePart><namePart type="family">Schuger</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Pathology, University of Michigan, Ann Arbor</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Deborah</namePart><namePart type="family">Boldea</namePart><namePart type="termsOfAddress">BS</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Linda</namePart><namePart type="family">McMath</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J. Richard</namePart><namePart type="family">Spears</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, Division of Cardiology, Wayne State University/Harper Hospital, Detroit</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Inc.</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">1990</dateIssued><dateValid encoding="w3cdtf">1989-12-14</dateValid><copyrightDate encoding="w3cdtf">1990</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">6</extent><extent unit="tables">1</extent><extent unit="references">31</extent></physicalDescription><abstract lang="en">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.</abstract><subject lang="en"><genre>Keywords</genre><topic>accessory pathways</topic><topic>Nd</topic><topic>YAG laser</topic><topic>angiography</topic></subject><relatedItem type="host"><titleInfo><title>Lasers in Surgery and Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Lasers Surg. Med.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Article</topic></subject><identifier type="ISSN">0196-8092</identifier><identifier type="eISSN">1096-9101</identifier><identifier type="DOI">10.1002/(ISSN)1096-9101</identifier><identifier type="PublisherID">LSM</identifier><part><date>1990</date><detail type="volume"><caption>vol.</caption><number>10</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>140</start><end>148</end><total>9</total></extent></part></relatedItem><identifier type="istex">8EB0CF33C3B4364CF0B3EA2F7D349585B6EB55EB</identifier><identifier type="DOI">10.1002/lsm.1900100206</identifier><identifier type="ArticleID">LSM1900100206</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Inc.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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