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Ultrasound Cardioscopy: Embarking on a New Journey

      Objective

      To present the results of investigation of a new application of invasive ultrasonography-ultrasound cardioscopy, a procedure in which a self-contained ultrasound device is capable not only of producing an under-blood field of view but also of delivering diagnostic and therapeutic tools.

      Design

      Twenty adult mongrel dogs were studied with the ultrasound cardioscopy device during experimental catheter ablation procedures.

      Material and Methods

      A rigid prototype probe, 34 cm long and 8 mm in diameter with a 7-MHz side-viewing transducer at the tip and an 8-F diameter tool delivery port, was introduced through the right external jugular vein into the right heart chambers. Remote and device-directed ablation procedures were monitored. Subsequently, the canine hearts were excised and examined.

      Results

      The self-contained cardioscopy device with a contained ablation catheter could both direct and visualize a specified ablation injury. Under-blood observation of the details of the ablation procedure was possible. Although a learning curve existed for appropriate manipulation of the device, inspection of the excised hearts showed that the size of the injury was accurately predicted with use of ultrasound cardioscopy.

      Conclusion

      Ultrasound cardioscopy is a promising means of performing precise under-blood diagnostic and therapeutic maneuvers.
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      Linked Article

      • Journeys Inside the Heart: Fantastic Voyages, but What Will Their Impact Be?
        Mayo Clinic ProceedingsVol. 71Issue 7
        • Preview
          In a report in 1922, Allen and Graham1 described the experimental use of a cardioscope to guide the surgical relief of mitral stenosis. Their cardioscope was a metal tube with a convex lens at one end and a small electric lightbulb placed against the lens to provide illumination. A knife to incise heart valves was attached to the side of the cardioscope. The cardioscope was inserted into the heart through the left atrial appendage, and when the lens was in contact with the mitral valve leaflets, excellent visualization was afforded.
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