| 钱俊,黄晶,杨刚,江永红,朱悫,刘地川,邓昌明.经多功能导管化学消融犬左心室前组乳头肌[J].中国医学影像技术,2020,36(7):976~980 |
| 经多功能导管化学消融犬左心室前组乳头肌 |
| Chemical ablation of anterior papillary muscle of canine left ventricle using multifunctional catheter |
| 投稿时间：2019-11-08 修订日期：2020-05-10 |
| DOI：10.13929/j.issn.1003-3289.2020.07.004 |
| 中文关键词: 心律失常,心性 超声心动描记术 导管消融 犬 |
| 英文关键词:arrhythmias, cardiac echocardiography atheter ablation dogs |
| 基金项目: |
|
| 摘要点击次数: 3259 |
| 全文下载次数: 826 |
| 中文摘要: |
| 目的 观察利用多功能心腔内超声（ICE）导管化学消融犬左心室前组乳头肌（APM）的可行性。方法 将15只杂交犬随机分均为0.2 ml组、0.4 ml组及0.8 ml组，每组5只。在ICE图像定位和监控下于左心室APM基底部注射不同剂量无水乙醇进行化学消融。于消融前及消融5天后行经胸超声，检测二尖瓣反流面积（MRA）及射流紧缩口宽度（VC）。之后处死动物，观察APM大体及病理变化。结果 ICE图像可清晰显示左心室APM结构，并实时监测进针深度及消融过程。消融5天后0.2 ml及0.4 ml组MRA、VC无明显改变，0.8 ml组MRA及VC较消融前明显增加（P均<0.05）。APM基底部可见中央呈苍白色的消融灶，0.2 ml、0.4 ml及0.8 ml无水乙醇在APM基底部形成的消融灶体积分别为（0.37±0.07）cm2、（0.69±0.08）cm2、（0.96±0.19）cm2，较高剂量组消融灶体积均大于较低剂量组（P均<0.05）。光镜下见消融灶内心肌细胞呈不可逆性坏死改变。结论 采用ICE导管注射低剂量无水乙醇可安全、有效消融左心室APM，有望为治疗左心室APM起源室性心律失常提供新的策略。 |
| 英文摘要: |
| Objective To observe the feasibility of chemical ablation of left ventricular (LV) anterior papillary muscle (APM) using multifunctional intracardiac echocardiography (ICE) catheter. Methods Fifteen hybrid canines were randomly divided into 0.2 ml, 0.4 ml and 0.8 ml injection groups (each n=5). Then the above doses of ethanol were injected into the base of LV APM under the location and monitoring of ICE images in each group, respectively. Mitral regurgitation area (MRA) and vena contracta (VC) were measured with transthoracic echocardiography before and 5 days after ablation. All animals were sacrificed 5 days after ablation, the general and pathological changes of APM were observed. Results ICE images clearly displayed the structure of LV APM and the depth of needle insertion and ablation process in real time. No significant difference of MRA nor VC was detected in 0.2 ml nor 0.4 ml group before and 5 days after ablation, but MRA and VC in in 0.8 ml group were both higher than those before ablation (all P<0.05). Pale ablation lesions in the base of APM were observed, the volume of ablation lesions formed by 0.2 ml, 0.4 ml and 0.8 ml absolute ethanol at the base of APM were (0.37±0.07)cm2, (0.69±0.08)cm2 and (0.96±0.19)cm2, respectively. The volume of ablation lesion in higher dose group was larger than that in lower dose group (all P<0.05). Irreversible necrosis of cardiomyocytes were observed in the ablation site under light microscopy. Conclusion Chemical ablation of APM is effectively and safely achieved with intramyocardial injection of small amount of ethanol, which may provide a new ablation strategy for treatment of ventricular arrhythmia originating from LV APM. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
