Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease
Delivery of electrosurgery energy through catheters and guidewires enables interventionists to ‘cut’ through obstructive intravascular lesions or across cardiac chambers. A novel application of transcatheter electrosurgery is to make controlled lacerations in heart valve leaflets. This review descri...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2021-03-01
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| Series: | US Cardiology Review |
| Online Access: | https://www.uscjournal.com/articleindex/usc.2020.27 |
| _version_ | 1797200072766652416 |
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| author | Jaffar M Khan Toby Rogers Adam B Greenbaum Vasilis C Babaliaros John C Lisko Dursun Korel Yildirim Christopher G Bruce Daniel A Herzka Kanishka Ratnayaka Robert J Lederman |
| author_facet | Jaffar M Khan Toby Rogers Adam B Greenbaum Vasilis C Babaliaros John C Lisko Dursun Korel Yildirim Christopher G Bruce Daniel A Herzka Kanishka Ratnayaka Robert J Lederman |
| author_sort | Jaffar M Khan |
| collection | DOAJ |
| description | Delivery of electrosurgery energy through catheters and guidewires enables interventionists to ‘cut’ through obstructive intravascular lesions or across cardiac chambers. A novel application of transcatheter electrosurgery is to make controlled lacerations in heart valve leaflets. This review describes three applications of transcatheter electrosurgery of aortic and mitral valve leaflets to enable transcatheter heart valve implantation. Intentional laceration of the anterior mitral leaflet to prevent left ventricular outflow obstruction splits and splays the anterior mitral valve and enables transcatheter mitral valve replacement without left ventricular outflow tract obstruction. Technique modifications and novel applications are described. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction enables transcatheter aortic valve replacement without coronary artery obstruction. The technique is described and novel uses, especially in the setting of repeat transcatheter aortic valve replacement, are discussed. Finally, electrosurgical laceration and stabilization of mitral valve clip devices (ELASTA-Clip) enables transcatheter mitral valve replacement after MitraClip implantation. In conclusion, transcatheter electrosurgery is an important and versatile new tool in structural heart intervention. |
| first_indexed | 2024-03-07T17:41:19Z |
| format | Article |
| id | doaj.art-c1b8ed5670224369aed0a918f53aef3e |
| institution | Directory Open Access Journal |
| issn | 1758-3896 1758-390X |
| language | English |
| last_indexed | 2024-04-24T07:25:50Z |
| publishDate | 2021-03-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | US Cardiology Review |
| spelling | doaj.art-c1b8ed5670224369aed0a918f53aef3e2024-04-20T16:02:05ZengRadcliffe Medical MediaUS Cardiology Review1758-38961758-390X2021-03-011510.15420/usc.2020.27Advances in Transcatheter Electrosurgery for Treating Valvular Heart DiseaseJaffar M Khan0Toby Rogers1Adam B Greenbaum2Vasilis C Babaliaros3John C Lisko4Dursun Korel Yildirim5Christopher G Bruce6Daniel A Herzka7Kanishka Ratnayaka8Robert J Lederman9Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MDCardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD; Medstar Washington Hospital Center, Washington, DCStructural Heart and Valve Center, Emory University Hospital, Atlanta, GAStructural Heart and Valve Center, Emory University Hospital, Atlanta, GAStructural Heart and Valve Center, Emory University Hospital, Atlanta, GACardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MDCardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MDCardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MDCardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD; UCSD Rady Children’s Hospital, San Diego, CACardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MDDelivery of electrosurgery energy through catheters and guidewires enables interventionists to ‘cut’ through obstructive intravascular lesions or across cardiac chambers. A novel application of transcatheter electrosurgery is to make controlled lacerations in heart valve leaflets. This review describes three applications of transcatheter electrosurgery of aortic and mitral valve leaflets to enable transcatheter heart valve implantation. Intentional laceration of the anterior mitral leaflet to prevent left ventricular outflow obstruction splits and splays the anterior mitral valve and enables transcatheter mitral valve replacement without left ventricular outflow tract obstruction. Technique modifications and novel applications are described. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction enables transcatheter aortic valve replacement without coronary artery obstruction. The technique is described and novel uses, especially in the setting of repeat transcatheter aortic valve replacement, are discussed. Finally, electrosurgical laceration and stabilization of mitral valve clip devices (ELASTA-Clip) enables transcatheter mitral valve replacement after MitraClip implantation. In conclusion, transcatheter electrosurgery is an important and versatile new tool in structural heart intervention.https://www.uscjournal.com/articleindex/usc.2020.27 |
| spellingShingle | Jaffar M Khan Toby Rogers Adam B Greenbaum Vasilis C Babaliaros John C Lisko Dursun Korel Yildirim Christopher G Bruce Daniel A Herzka Kanishka Ratnayaka Robert J Lederman Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease US Cardiology Review |
| title | Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease |
| title_full | Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease |
| title_fullStr | Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease |
| title_full_unstemmed | Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease |
| title_short | Advances in Transcatheter Electrosurgery for Treating Valvular Heart Disease |
| title_sort | advances in transcatheter electrosurgery for treating valvular heart disease |
| url | https://www.uscjournal.com/articleindex/usc.2020.27 |
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