Laser Atrial Septostomy: An Engineering Problem

Giora Ben-Shachar; Mark H. Cohen; Thomas A. Riemenschneider; Stanley D. Beder

doi:10.1117/12.937366

1 April 1987 Laser Atrial Septostomy: An Engineering Problem

Giora Ben-Shachar, Mark H. Cohen, Thomas A. Riemenschneider, Stanley D. Beder

Proceedings Volume 0713, Optical Fibers in Medicine II; (1987) https://doi.org/10.1117/12.937366
Event: Cambridge Symposium-Fiber/LASE '86, 1986, Cambridge, MA, United States

Abstract

The purpose of this study was to develop a reproducible method for atrial septostomy in live animals, which would be independent of both atrial septal thickness and left atrial size. Seven mongrel dogs monitored electrocardiographically were anesthetized and instrumented with systemic and pulmonary arterial lines. A modified Mullin's transseptal sheath was advanced under fluoroscopic control to interrogate the left atrium and atrial septum. A 400 micron regular quartz or a laser heated metallic tip fiber was passed through the sheath up to the atrial septum. Lasing of the atrial septum was done with an Argon laser at power output of 5 watts. In three dogs, an atrial septosomy catheter was passed to the left atrium through the laser atrial septostomy and balloon atrial septostomy was performed. The laser atrial septostomy measured 3 x 5 mm in diameter. This interatrial communication could be enlarged with a balloon septostomy to over one cm in diameter. Hemodynamic and electrocardiographic monitoring were stable during the procedure. Engineering problems included: 1) radioluscency of the laser fibers thus preventing fluoroscopic localization of the fiber course; and 2) the inability to increase lateral vaporization of the atrial septum. It is concluded that further changes in the lasing fibers need to be made before the method can be considered for clinical use.

Citation Download Citation

Giora Ben-Shachar, Mark H. Cohen, Thomas A. Riemenschneider, and Stanley D. Beder "Laser Atrial Septostomy: An Engineering Problem", Proc. SPIE 0713, Optical Fibers in Medicine II, (1 April 1987); https://doi.org/10.1117/12.937366

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