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一种新型冷冻消融系统的评估:热容量和冷冻温度的体外测试

Evaluation of a novel cryoablation system: in vitro testing of heat capacity and freezing temperatures.

作者信息

Weimar Timo, Lee Anson M, Ray Shuddhadeb, Schuessler Richard B, Damiano Ralph J

机构信息

Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO 63110, USA.

出版信息

Innovations (Phila). 2012 Nov-Dec;7(6):403-9. doi: 10.1177/155698451200700606.

Abstract

OBJECTIVE

Cryoablation has been used to ablate cardiac tissue for decades and has been shown to be able to replace incisions in the surgical treatment of atrial fibrillation. This in vitro study evaluates the performance of a novel cryoprobe and compares it with existing commercially available devices.

METHODS

A new malleable 10-cm aluminum cryoprobe was compared with a rigid 3.5-cm copper linear probe using in vitro testing to evaluate performances under different thermal loads and with different tissue thicknesses. Radial dimensions of ice formation were measured in each water bath by a high-precision laser 2 minutes after the onset of cooling. Probe-surface temperatures were recorded by thermocouples. Tissue temperature was measured at depths of 4 mm and 5 mm from the probe-tissue interface. Time to reach a tissue temperature of -20°C was recorded.

RESULTS

Ice formation increased significantly with lower water-bath temperatures (P < 0.001). Width and depth of ice formation were significantly less for the rigid linear probe (P < 0.012 and P < 0.001, respectively). There was no difference between the probes in the maximal negative temperature reached under different thermal loads or at different tissue depths. The malleable probe achieved significantly lower temperatures at the proximal compared with the distal end (-61.7°C vs -55.0°C, respectively; P < 0.001). A tissue temperature of -20°C was reached earlier at 4 mm than at 5 mm (P < 0.001) and was achieved significantly faster with the 3011 Maze Linear probe (P < 0.021).

CONCLUSIONS

The new malleable probe achieved rapid freezing to clinically relevant levels in up to 5-mm-thick tissue. Both probes maintained their performance under a wide range of thermal loads.

摘要

目的

冷冻消融用于心脏组织消融已有数十年,且已证明在心房颤动的外科治疗中能够替代切口。本体外研究评估了一种新型冷冻探头的性能,并将其与现有的商用设备进行比较。

方法

使用体外测试将一种新型可弯曲的10厘米铝制冷冻探头与一个刚性的3.5厘米铜制线性探头进行比较,以评估在不同热负荷和不同组织厚度下的性能。在冷却开始2分钟后,通过高精度激光在每个水浴中测量冰形成的径向尺寸。用热电偶记录探头表面温度。在距探头 - 组织界面4毫米和5毫米的深度处测量组织温度。记录达到 -20°C组织温度的时间。

结果

随着水浴温度降低,冰形成显著增加(P < 0.001)。刚性线性探头的冰形成宽度和深度显著更小(分别为P < 0.012和P < 0.001)。在不同热负荷或不同组织深度下达到的最大负温度方面,探头之间没有差异。可弯曲探头近端的温度明显低于远端(分别为 -61.7°C和 -55.0°C;P < 0.001)。在4毫米处比在5毫米处更早达到 -20°C的组织温度(P < 0.001),并且使用3011迷宫线性探头能显著更快达到(P < 0.021)。

结论

新型可弯曲探头在高达5毫米厚的组织中能快速冷冻至临床相关水平。两种探头在广泛的热负荷下均保持其性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c4a/3578216/c62d24f52d28/nihms440297f1.jpg

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