Cardiac intervention using high‐intensity focused ultrasound: creation of interatrial communication in beating heart of an anesthetized rabbit

Objective Current fetal cardiac intervention for restrictive atrial septum is invasive and technically demanding. We investigated the feasibility of computer‐assisted high‐intensity focused ultrasound (HIFU) for cardiac intervention on the atrial septum of a beating heart. Methods To create an inter...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2010-11, Vol.36 (5), p.607-612
Main Authors: Fujisaki, M., Chiba, T., Enosawa, S., Dohi, T., Takamoto, S.
Format: Article
Language:English
Subjects:
Animals
Atrial Septum
balloon atrioseptostomy
BAS
Biological and medical sciences
cardiac intervention
Computer programs
computer‐assisted
Feasibility Studies
Fetuses
Gynecology
Gynecology. Andrology. Obstetrics
Heart
HIFU
High-Intensity Focused Ultrasound Ablation - adverse effects
High-Intensity Focused Ultrasound Ablation - methods
highly restrictive atrial septum
high‐intensity focused ultrasound
imaging
Male
Medical sciences
Obstetrics
Probes
Rabbits
Septum
software
Tamponade
Therapy, Computer-Assisted - methods
Transducers
Ultrasound
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Summary:Objective Current fetal cardiac intervention for restrictive atrial septum is invasive and technically demanding. We investigated the feasibility of computer‐assisted high‐intensity focused ultrasound (HIFU) for cardiac intervention on the atrial septum of a beating heart. Methods To create an interatrial communication in the beating heart of nine anesthetized rabbits, the heart was exposed surgically and placed under a water‐filled tank, in contact with the tank's membranous base. A HIFU transducer (3.3 MHz) coupled with a diagnostic ultrasound probe (10.0 MHz) was placed in the tank over the beating heart. The focus of the HIFU transducer was set so that it could create a hole in the target area on the atrial septum during the early diastolic phase. HIFU delivery was controlled based on ultrasound images captured with real‐time image‐recognition software. We attempted to create interatrial communication using HIFU and assessed the cardiac tissue specimen pathologically. Results In eight of nine rabbits, small holes in the atrial septum were successfully created. Serious complications occurred in two animals: a fatal atrioventricular block in one and a cardiac tamponade in the other. Conclusion HIFU combined with a computer‐assisted imaging system might be useful to create interatrial communication in beating hearts. This procedure may be helpful for making current fetal cardiac intervention less invasive. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN:0960-7692
1469-0705
1469-0705
DOI:10.1002/uog.8830