Abstract
In recent years, several fetal cardiac malformations have been increasingly treated before birth with gradually improved outcome, although the technique is still demanding and invasive. We newly developed a computer-aided system for energy delivery of high-intensity focused ultrasound (HIFU) to correct cardiac morphologic abnormalities in vivo much less invasively. The HIFU system could be controlled in real-time by a computer-based analysis of 2D-sonographic left ventricular images for optimal triggering off HIFU. Using beating heart of two anesthetized adult rabbits, the system successfully achieved a non-touch gross ablation of the atrial septum in one animal, and in the other HIFU energy was inadvertently mistargeted on the posterior wall of the left atrium with a resultant small transmural opening. We believe that the HIFU system will be introduced with pinpoint accuracy to minimally invasive treatment of fetal cardiac abnormalities that have intact or highly restrictive atrial septum.
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Kohl, T., Sharland, G., Allan, L.D., Gembruch, U., Chaoui, R., Lopes, L.M., Zielinsky, P., Huhta, J., Silverman, N.H.: World experience of percutaneous ultrasound-guided balloon valvuloplasty in human fetuses with severe aortic valve obstruction. Am. J. Cardiol. 85, 1230–1233 (2000)
Marshall, A.C., van der Velde, M.E., Tworetzky, W., Gomez, C.A., Wilkins-Haung, L., Benson, C.B., Jennings, R.W., Lock, J.E.: Creation of an atrial septal defect in utero for fetuses with hypoplastic left heart syndrome and intact or highly restrictive atrial septum. Circulation 110, 253–258 (2004)
Makikallio, K., McElhinney, D.B., Levine, J.C., Marx, G.R., Colan, S.D., Marshall, A.C., Lock, J.E., Marcus, E.N., Tworetzky, W.: Fetal Aortic valve stenosis and the evolution of hypoplastic left heart syndrome patient selection for fetal intervention. Circulation 113, 1401–1405 (2006)
Rebillard, X., Gelet, A., Davin, J.L., Soulie, M., Prapotnich, D., Cathelineau, X., Rozet, F., Vallancien, G.: Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer. J. Endourol. 19(6), 693–701 (2005)
Chan, A.H., Fujimoto, V.Y., Moore, D.E., Martin, R.W., Vaezy, S.: An image-guided high intensity focused ultrasound device for uterine fibroids treatment. Med. Phys. 29(11), 2611 (2002)
Hengst, S.A., Ehrenstein, T., Herzog, H., Beck, A., Utz-Billing, I., David, M., Felix, R., Ricke, J.: Magnetic resonance tomography guided focused ultrasound surgery (MRgFUS) in tumor therapy?anew noninvasive therapy option. Radiologe 44(4), 339–346 (2004)
U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health. Guide for the care and use of laboratory animals, pp. 85–23. NIH Publication (1985)
Otsuka, R., Fujikura, K., Hirata, K., Pulerwitz, T., Oe, Y., Suzuki, T., Sciacca, R., Marboe, C., Wang, J., Burkhoff, D., Muratore, R., Lizzi, F.L., Homma, S.: In vitro ablation of cardiac valves using high-intensity focused ultrasound. Ultrasound in Med. & Biol. 31(1), 109–114 (2005)
Fujikura, K., Otsuka, R., Kalisz, A., Ketterling, J.A., Jin, Z., Sciacca, R.R., Marboe, C.C., Wang, J., Muratore, R., Feleppa, E.J., Homma, S.: Effects of ultrasonic exposure parameters on myocardial lesions induced by high-intensity focused ultrasound. J. Ultrasound Med. 25, 1375–1386 (2006)
Lee, L.A., Simon, C., Bove, L.E., Mosca, R.S., Ebbini, E.S., Abrams, G.D., Ludomirsky, A.: High intensity focused ultrasound effect on cardiac tissues: Potential for Clinical application. Echocardiography 17(6), 563–566 (2000)
Xu, Z., Ludmirsky, A., Eun, L.Y., Hall, T.L., Tran, B.C., Fowlkes, J.B., Cain, C.A.: Controlled ultrasound tissue erosion. IEEE transactions on ultrasonics, ferroelectrics, and frequency control 51(6), 726–736 (2004)
Kluiwstra, J.U.A., Tokano, T., Davis, J., Strickberger, S.A., Cain, C.A.: Real time image guided high intensity focused ultrasound for myocardial ablation: In Vivo study. In: IEEE Ultrasonics Symposium, vol. 1327 (2007)
Strickberger, S.A., Tokano, T., Kluiwstra, J.U.A., Morady, F., Cain, C.: Extracardiac ablation of the canine atrioventricular junction by use of high-intensity focused ultrasound. Circulation 100, 203–208 (1999)
Koizumi, N., Ota, K., Lee, D., Yoshizawa, S., Ito, A., Kaneko, Y., Yoshinaka, K., Matsumoto, Y., Mitsuishi, M.: Feed-forward controller for the integrated non-invasive ultrasound diagnosis and treatment. J. Robotics and Mechatronics 20(1), 89–97 (2008)
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Yamashita, H. et al. (2008). Computer-Aided Delivery of High-Intensity Focused Ultrasound (HIFU) for Creation of an Atrial Septal Defect in Vivo. In: Dohi, T., Sakuma, I., Liao, H. (eds) Medical Imaging and Augmented Reality. MIAR 2008. Lecture Notes in Computer Science, vol 5128. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79982-5_33
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DOI: https://doi.org/10.1007/978-3-540-79982-5_33
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