Radiofrequency perforation of the pulmonary valve: an efficient low cost solution.
Acta Cardiol
; 72(4): 419-424, 2017 Aug.
Article
in En
| MEDLINE
| ID: mdl-28705054
ABSTRACT
Objective The aim of the study was to assess the feasibility of using commonly available catheterization laboratory equipment for radiofrequency perforation of the pulmonary valve in patients with pulmonary atresia and intact ventricular septum. Methods The system (off-label use for all items) is made up of a co-axial telescopic arrangement consisting of a 0.014" PT 2 ™ coronary guidewire, for insulation inside a 2.7-F microcatheter which has an inner lumen of 0.021". The microcatheter was passed via a standard 4-F right coronary catheter to just below the atretic pulmonary valve. Radiofrequency (RF) energy was delivered using a standard electrosurgical system. In vitro testing had been performed and indicated that 5-10 W for 2-5 s would be sufficient for valve perforation. Results Radiofrequency perforation was successfully performed in all (n = 5, 100%) patients at a median age of 3â¯days (range 1-36) and weight 2.7â¯kg (range 2.3-3.0). In one patient the pericardium was entered during the initial attempt; the generator was put on coagulation mode during retrieval of the guidewire and no haemopericardium occurred. The pulmonary valve was dilated in all; in three patients (n = 3) the ductus arteriosus was stented during the same session. Conclusion Results of the study show that it is feasible to perforate the pulmonary valve safely using this system. Availability, simplicity and cost are noteworthy benefits.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pulmonary Valve
/
Catheter Ablation
/
Angioplasty, Balloon
/
Pulmonary Atresia
/
Heart Defects, Congenital
Type of study:
Health_economic_evaluation
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Acta Cardiol
Year:
2017
Type:
Article
Affiliation country:
Belgium