Therapeutic ultrasound to noninvasively create intracardiac communications in an intact animal model.
Therapeutic ultrasound to noninvasively create intracardiac communications in an intact animal model.
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DOI：
10.1002/ccd.22787
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发表时间：
2011-03-01
影响因子：
2.3
通讯作者：
Xu, Zhen
中科院分区：
文献类型：
--
作者：
Owens, Gabe E.;Miller, Ryan M.;Ensing, Greg;Ives, Kimberly;Gordon, David;Ludomirsky, Achi;Xu, Zhen
为了确定脉冲空化超声治疗（组织学检查）是否可以通过新生动物的完整胸部准确、安全地产生室间隔缺损（VSDs），最终目标是开发一种无创技术，在先天性心脏病患者中建立心内通信。组织切片是一种创新的超声技术，利用高强度超声脉冲产生划界的机械组织分离。先前的工作表明，在开胸犬模型中，组织学检查可以在跳动的心脏中产生房间隔缺陷。对9头新生猪进行了针对室间隔的经皮组织切片。利用1 MHz聚焦换能器，在峰值负压为13 MPa、脉冲重复频率为1 kHz的条件下，产生持续时间为5μs的超声脉冲。该过程由实时超声成像指导。在所有猪中都建立了直径在2-6.5mm之间的vsd。6只猪在治疗2小时内安乐死，3只猪恢复并维持2 - 3天，以评估病变成熟度和临床副作用。只有短暂的临床效果，病理显示VSD周围有轻微的附带损伤，其他心脏或心脏外结构无明显损伤。在新生动物模型中，组织切片法可以准确、安全地通过完整的胸部生成室间隔缺损。这些结果表明，随着进一步的进展，组织切片术可以成为一种有用的、非侵入性的技术来建立心脏内通信，目前需要侵入性导管或外科手术来临床稳定患有复杂先天性心脏病的新生儿。
To determine if pulsed cavitational ultrasound therapy (histotripsy) can accurately and safely generate ventricular septal defects (VSDs) through the intact chest of a neonatal animal, with the eventual goal of developing a non-invasive technique of creating intra-cardiac communications in patients with congenital heart disease. Histotripsy is an innovative ultrasonic technique that generates demarcated, mechanical tissue fractionation utilizing high intensity ultrasound pulses. Previous work has shown that histotripsy can create atrial septal defects in a beating heart in an open-chest canine model. Nine neonatal pigs were treated with transcutaneous histotripsy targeting the ventricular septum. Ultrasound pulses of 5μs duration at a peak negative pressure of 13 MPa and a pulse repetition frequency of 1 kHz were generated by a 1 MHz focused transducer. The procedure was guided by real-time ultrasound imaging. VSDs were created in all pigs with diameters ranging from 2–6.5mm. Six pigs were euthanized within 2 hrs of treatment, while 3 were recovered and maintained for 2–3 days to evaluate lesion maturation and clinical side effects. There were only transient clinical effects and pathology revealed mild collateral damage around the VSD with no significant damage to other cardiac or extra-cardiac structures. Histotripsy can accurately and safely generate VSDs through the intact chest in a neonatal animal model. These results suggest that with further advances, histotripsy can be a useful, non-invasive technique to create intra-cardiac communications, which currently require invasive catheter-based or surgical procedures, to clinically stabilize newborn infants with complex congenital heart disease.
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影响因子：
2.4
作者：
Xu, Z;Fowlkes, JB;Cain, CA
通讯作者：
Cain, CA
影响因子：
2.8
作者：
LENOX, CC;ZUBERBUHLER, JR
通讯作者：
ZUBERBUHLER, JR
DOI：
10.1016/j.jtcvs.2006.09.037
发表时间：
2007-04-01
影响因子：
6
作者：
Meadows, Jeffery;Pigula, Frank;Marshall, Audrey
通讯作者：
Marshall, Audrey
影响因子：
2.4
作者：
FOWLKES, JB;CRUM, LA
通讯作者：
CRUM, LA
影响因子：
19.7
作者：
Tempany, CMC;Stewart, EA;Hynynen, K
通讯作者：
Hynynen, K