1997 Fiscal Year Final Research Report Summary
Development of Transcatheter Surgical Suture Closure of Congenital Intracardiac Defects
| Project/Area Number |
07670893
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Pediatrics
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| Research Institution | Saitama Medical School |
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Principal Investigator |
KOIKE Kazuyuki Saitama Medical School, Department of Pediatrics, Professor of Pediatrics, 医学部, 教授 (00245193)
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| Co-Investigator(Kenkyū-buntansha) |
KOBAYASHI Toshiki Saitama Medical School, Department of Pediatrics, Assistant Professor of Pediatr, 医学部, 講師 (30215347)
KYO Shunei Saitama Medical School, Department of Surgery, Professor of Surgery, 医学部, 教授 (30153232)
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| Project Period (FY) |
1995 – 1997
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| Keywords | Congenital heart disease / Atrial septal defect / Interventional catheterization / Transcatheter closure / Intracardiac ultrasound imaging / Three-dimensional reconstruction |
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| Research Abstract |
Recently available transcatheter intracardiac defect closure methods always use predesigned devices and only applicable to small central defects. We aimed to develop atranscatheter surgical closure technique which is universally applicable to most of the patients with intracardiac defects.
We proved the Intracardiac ultrasound (ICUS) be useful to visualize the defects and monitor the procedure. Aloka's reusable rotational ICUS probe driven with Tomtec Echoscan could automatically make a three-dimensional reconstruction (3DR) image of the defect. We have found that the size of atrial septal defect (ASD) changed significantly in cardiac cycle. It is minimum in end-diasrole and maximum in end-systole ; 2.3 times bigger in average. This is one of the reasons why preformed device is limited in use for ASD closure. ICUS was proved useful to image the defect and transcatheter surgical device in pig model.
We invented the transcatheter ASD surgical suture closure device. Suture strength measured
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in pig specimen was at least 10 times larger than the developed atrial wall tension. Under general anesthesia with intratracheal intubation, infant pig's femoral vein was canulated percutaneously. We could puncture and leave the thread at the edge of the ASD using a puncture/suture needlel. We have also developed a puncture/suture anchor device. This device punctured the defect edge and stayd the anchor with suture thread. Two sutures at the opposite sides of the defect could be tied up with a tying/cutting device and successfully close the defect as large as 5mm in diameter. This was presented at the 2nd World Congress of Pediatric Cardiology and Cardiac Surgery in May 1997. We have also developed a transcatheter surgical patch closure method usng a Nitinol wire framed Dacron patch for larger defects. This patch is to be sutured with the puncture/suture anchor device. Defect edge puncture was facilitated with a septum retracting device.
We concluded that the transcatheter surgical suture closure of the intracardiac defects be technically feasible and we will refine transcatheter devices for the clinical use at the next research term. Less
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