TY - JOUR
T1 - Resection of calcified aortic heart leaflets in vitro by Q-switched 2-μm microsecond laser radiation
AU - Rohde, I.
AU - Masch, J. M.
AU - Theisen-Kunde, D.
AU - Marczynski-Bühlow, M.
AU - Bombien Quaden, R.
AU - Lutter, G.
AU - Brinkmann, R.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background Transcatheter aortic valve implantation (TAVI) can result in paravalvular leakage and stent deformation in the presence of severe calcification. This study was undertaken to determine the efficacy of laser-assisted resection of calcific aortic valve leaflets as a method to minimize the effects of calcium on perivalvular leakage during TAVI. Methods A Q-switched Tm:YAG laser emitting at a wavelength of 2.01-μm was used to evaluate the cutting efficiency on highly calcified human aortic leaflets in vitro (N-=-10). A pulse energy of 4.3-mJ, a pulse duration of 0.8-1-μs, and a repetition rate of 1-kHz were used. The radiation was transmitted via a 200-μm core diameter quartz fiber. Resection was performed in a fiber-tissue contact mode on water-covered samples in a dish. The remnant particles were analyzed with respect to quantity and size by light microscopy. Results A resection rate of 40.4-±-22.2-mg/min on highly calcified aortic leaflets was achieved. This corresponds to a cutting speed of approximately 1-cm/min; a laser dissection time of 3-min per leaflet is expected. The majority of the remnant particles (85.4%) were <6-μm in diameter, with only 0.1% exceeding 300-μm. Conclusions The Q-switched Tm:YAG laser system showed promising results in cutting calcified aortic valves, by transmitting sufficient energy through a small flexible fiber. Catheter-based removal of aortic valve calcification may help to improve TAVI technology. doi: 10.1111/jocs.12481 (J Card Surg 2015;30:157-162)
AB - Background Transcatheter aortic valve implantation (TAVI) can result in paravalvular leakage and stent deformation in the presence of severe calcification. This study was undertaken to determine the efficacy of laser-assisted resection of calcific aortic valve leaflets as a method to minimize the effects of calcium on perivalvular leakage during TAVI. Methods A Q-switched Tm:YAG laser emitting at a wavelength of 2.01-μm was used to evaluate the cutting efficiency on highly calcified human aortic leaflets in vitro (N-=-10). A pulse energy of 4.3-mJ, a pulse duration of 0.8-1-μs, and a repetition rate of 1-kHz were used. The radiation was transmitted via a 200-μm core diameter quartz fiber. Resection was performed in a fiber-tissue contact mode on water-covered samples in a dish. The remnant particles were analyzed with respect to quantity and size by light microscopy. Results A resection rate of 40.4-±-22.2-mg/min on highly calcified aortic leaflets was achieved. This corresponds to a cutting speed of approximately 1-cm/min; a laser dissection time of 3-min per leaflet is expected. The majority of the remnant particles (85.4%) were <6-μm in diameter, with only 0.1% exceeding 300-μm. Conclusions The Q-switched Tm:YAG laser system showed promising results in cutting calcified aortic valves, by transmitting sufficient energy through a small flexible fiber. Catheter-based removal of aortic valve calcification may help to improve TAVI technology. doi: 10.1111/jocs.12481 (J Card Surg 2015;30:157-162)
UR - http://www.scopus.com/inward/record.url?scp=84921753775&partnerID=8YFLogxK
U2 - 10.1111/jocs.12481
DO - 10.1111/jocs.12481
M3 - Journal articles
C2 - 25530080
AN - SCOPUS:84921753775
SN - 0886-0440
VL - 30
SP - 157
EP - 162
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 2
ER -