Key result
Transcatheter electrosurgery enables novel structural heart procedures via radiofrequency tissue vaporization and laceration.
Why the study?
Transcatheter electrosurgery enables novel therapeutic procedures for structural heart disease by using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In the case of Mr Chua, the precision offered by this technique allowed us to overcome anatomical obstacles that would have been extremely risky with conventional methods.”
“At Transmural Systems, our mission has always been to simplify complex structural heart procedures through innovation. The FDA's clearance of TELLTALE reinforces our commitment to delivering a platform of intuitive, high-impact technologies that empower clinicians and improve patient outcomes.”
Transcatheter electrosurgery using radiofrequency energy enables a range of novel therapeutic procedures for structural heart disease, including tissue traversal and leaflet laceration.
Transcatheter electrosurgery refers to a family of procedures using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood. The authors review theory, simulations, and benchtop demonstrations of how guidewires, insulation, adjunctive catheters, and dielectric medium interact. For tissue traversal, all but the tip of traversing guidewires is insulated to concentrate current. For leaflet laceration, the "Flying V" configuration concentrates current at the inner lacerating surface of a kinked guidewire. Flooding the field with non-ionic dextrose eliminates alternative current paths. Clinical applications include traversing occlusions (pulmonary atresia, arterial and venous occlusion, and iatrogenic graft occlusion), traversing tissue planes (atrial and ventricular septal puncture, radiofrequency valve repair, transcaval access, Potts and Glenn shunts), and leaflet laceration (BASILICA, LAMPOON, ELASTA-Clip, and others). Tips are provided for optimizing these techniques. Transcatheter electrosurgery already enables a range of novel therapeutic procedures for structural heart disease, and represents a promising advance toward transcatheter surgery.
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Khan et al. (2020) conducted a review in Structural heart disease. Transcatheter electrosurgery was evaluated. Transcatheter electrosurgery enables a range of novel therapeutic procedures for structural heart disease by using radiofrequency energy to vaporize and traverse or lacerate tissue.
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