<title>Percutaneous intracardiac surgery with cardioscopic guidance</title>

Abstract

The feasibility of a novel catheter system of percutaneous transluminal cardiomyotomy and valvulotomy was examined in anesthetized dogs. The system was composed of a guiding balloon catheter, a cardioscope and a pair of scissors with or without guide wire at the distal tip. The system without guide wire was introduced into the left ventricle, the balloon was inflated and was pushed against the endocardial surface. After confirmation by cardioscopy, the targeted tissues were incised by the scissors. By these maneuvors, the trabeculae, papillary muscles and chordae were incised or transected in 7, 6 and 6 of 7 dogs, respectively. The system without guide wire was advanced to the aortic root, the guide wire was introduced into the left ventricle to prevent dislocation of the catheter system, balloon was manipulated against the aortic cusp, and the cusp was successfully incised with cardioscopic guidance in all 5 dogs. The result indicate that percutaneous transluminal cardiomyotomy and valvulotomy can be performed with cardioscopic guidance.

Imaging of Subendocardial Myocardial Blood Flow by Dye-Staining Cardioscopy in Patients With Coronary Artery Disease

“…16,17) Therefore, this dye can be used clinically not only to evaluate SMBF but also to achieve pin-point guidance of transendocardial angiogenic and myogenic therapies [20][21][22][23][24][25] and intracardiac surgery such as laser myocardial revascularization. 26) Conclusions: SMBF was evaluated by DSC using EB as an indicator of myocardial blood flow in patients with coronary artery disease. SMBF pattern was classified as diffuse, patchy, and no flow.…”

Recent Advances in Percutaneous Cardioscopy

“…Biopsy specimens obtained from red and milky white segments exhibited histological changes indicative of acute myocarditis, purple segments of active chronic myocarditis, and yellowish brown and white segments of inactive chronic myocarditis (Fig. 3) [13, 15, 16].

Fig.

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“…Thus, left ventricular endocardial colors that were observed by cardioscopy represented histological stages of idiopathic myocarditis. This imaging tool is therefore considered to be feasible for staging and follow-up of idiopathic myocarditis [13, 15, 16]. …”