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Delivery Sheath (delivery + sheath)
Selected AbstractsInitial Clinical Experience with Cardiac Resynchronization Therapy Utilizing a Magnetic Navigation SystemJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2007PETER GALLAGHER M.D. Introduction: The placement of left ventricular (LV) leads during cardiac resynchronization therapy (CRT) involves many technical difficulties. These difficulties increase procedural times and decrease procedural success rates. Methods and Results: A total of 50 patients with severe cardiomyopathy (mean LV ejection fraction was 21 ± 6%) and a wide QRS underwent CRT implantation. Magnetic navigation (Stereotaxis, Inc.) was used to position a magnet-tipped 0.014, guidewire (CronusÔ guidewire) within the coronary sinus (CS) vasculature. LV leads were placed in a lateral CS branch, either using a standard CS delivery sheath or using a "bare-wire" approach without a CS delivery sheath. The mean total procedure time was 98.1 ± 29.1 minutes with a mean fluoroscopy time of 22.7 ± 15.1 minutes. The mean LV lead positioning time was 10.4 ± 7.6 minutes. The use of a delivery sheath was associated with longer procedure times 98 ± 32 minutes vs 80 ± 18 minutes (P = 0.029), fluoroscopy times 23 ± 15 minutes vs 13 ± 4 minutes (P = 0.0007) and LV lead positioning times 10 ± 6 minutes vs 4 ± 2 minutes (P = 0.015) when compared to a "bare-wire" approach. When compared with 52 nonmagnetic-assisted control CRT cases, magnetic navigation reduced total LV lead positioning times (10.4 ± 7.6 minutes vs 18.6 ± 18.9 minutes; P = 0.005). If more than one CS branch vessel was tested, magnetic navigation was associated with significantly shorter times for LV lead placement (16.2 ± 7.7 minutes vs 36.4 ± 23.4 minutes; P = 0.004). Conclusions: Magnetic navigation is a safe, feasible, and efficient tool for lateral LV lead placement during CRT. Magnetic navigation during CRT allows for control of the tip direction of the CronusÔ 0.014, guidewire using either a standard CS delivery sheath or "bare-wire" approach. Although there are some important limitations to the 0.014, CronusÔ magnetic navigation can decrease LV lead placement times compared with nonmagnetic-assisted control CRT cases, particularly if multiple CS branches are to be tested. [source] Figulla ASD Occluder versus Amplatzer Septal Occluder: A Comparative Study on Validation of a Novel Device for Percutaneous Closure of Atrial Septal DefectsJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2009AYSENUR PAC M.D. Objectives: Occlutech Figulla ASD Occluder (FSO) is an alternative device to Amplatzer Septal Occluder (ASO) with some structural innovations including increased flexibility, minimizing the amount of material implanted, and absence of the left atrial clamp. We aimed to report our experiences with FSO and compare the outcomes of this novel device versus ASO. Interventions: Between December 2005 and February 2009, 75 patients diagnosed with secundum atrial septal defects underwent transcatheter closure. The FSO device was used in 33 patients, and the ASO was used in 42. Results: Patient characteristics, stretch size of the defect, device left disc size, procedure, and fluoroscopy time were similar between the groups. However, the difference between device waist size and stretched diameter of the defect was significantly higher, and device delivery sheath was significantly larger in FSO group and device left disc size was significantly lower in the FSO group. In all subjects, the residual shunt was small to trivial during follow-up and the reduction in prevalence of residual shunt with time was similar in both groups (P = 0.68). We found no differences in complication rate between the two devices; however, device embolization to the pulmonary bifurcation in one patient was recorded as major complication in FSO device group. Conclusions: Both devices are clinically safe and effective in ASD closure. FSO device has similar outcomes when compared to ASO device. Difficulties in selecting the correct device size in larger defects and larger venous sheath requirement need to be evaluated in further studies. [source] Delivery sheath tear after modification for ASD closureCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2006FSCAI, Mark H. Hoyer MD Abstract During transcatheter closure of an atrial septal defect with insufficient aortic rim, a standard delivery sheath was modified by cutting a bevel at the distal tip to improve device orientation. The sheath split longitudinally when attempting to recapture the closure device. Troubleshooting allowed a device to be implanted successfully. Pitfalls regarding our sheath modification and methods to overcome prolapse of the left atrial disk into the right atrium are discussed. © 2006 Wiley-Liss, Inc. [source] | ||||||||||