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Special Section Technical Briefs

A Single-Incision Delivery Tool for Epicardial Pacing and Defibrillation1

[+] Author and Article Information
Justin D. Opfermann, Axel Krieger

Sheikh Zayed Institute for Pediatric Surgical Innovation,
Children's National Health System,
Washington, DC 20010

Bradley C. Clark

Division of Cardiology,
Children's National Health System,
Washington, DC 20010

Tanya D. Davis

Division of Urology,
Children's National Health System,
Washington, DC 20010

Charles I. Berul

Sheikh Zayed Institute for Pediatric Surgical Innovation,
Children's National Health System,
Washington, DC 20010;
Division of Cardiology,
Children's National Health System,
Washington, DC 20010;
Department of Pediatrics,
George Washington University School of Medicine,
Washington, DC 20037

DOI: 10.1115/1.4033123Manuscript received March 1, 2016; final manuscript received March 16, 2016; published online May 12, 2016. Editor: William Durfee.

J. Med. Devices 10(2), 020930 (May 12, 2016) (2 pages) Paper No: MED-16-1063; doi: 10.1115/1.4033123 History: Received March 01, 2016; Revised March 16, 2016

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References

Walther, T. , Rastan, A. , Dähnert, I. , Falk, V. , Jacobs, S. , Mohr, F. W. , and Kostelka, M. , 2005, “ A Novel Adhesion Barrier Facilitates Reoperations in Complex Congenital Cardiac Surgery,” J. Thorac. Cardiovasc. Surg., 129(2), pp. 359–363. [CrossRef] [PubMed]
Jordan, C. , Wu, K. , Costello, J. , Ishibashi, N. , Krieger, A. , Kane, T. , Kim, P. , and Berul, C. , 2013, “ Minimally Invasive Resynchronization Pacemaker: A Pediatric Animal Model,” Ann. Thorac. Surg., 96(6), pp. 2210–2213. [CrossRef] [PubMed]
Clark, B. C. , Davis, T. , Ahmed, M. M. E.-S. , McCarter, R. , Ishibashi, N. , Jordan, C. P. , Kane, T. D. , Kim, P. C. , Krieger, A. , Nath, D. S. , Opfermann, J. , and Berul, C. I. , 2015, “ Minimally Invasive Percutaneous Pericardial ICD Placement in an Infant Piglet Model: Head-to-Head Comparison With an Open Surgical Thoracotomy Approach,” Heart Rhythm (in press).
Chen, H. N. , Lin, J. G. , Yang, A. , and Chang, S. K. , 2008, “ Safe Depth of Abdominal Acupoints in Pediatric Patients,” Complementary Ther. Med., 16(6), pp. 331–335. [CrossRef]
Crick, S. , Sheppard, M. , Ho, S. Y. , Gebstein, L. , and Anderson, R. , 1998, “ Anatomy of the Pig Heart: Comparisons With Normal Human Cardiac Structure,” J. Anat., 193(Pt. 1), pp. 105–119. [CrossRef] [PubMed]

Figures

Grahic Jump Location
Fig. 1

A prototype single-incision delivery tool used ex vivo and in vivo to implant leads in the pericardial space

Grahic Jump Location
Fig. 2

Illustration of the procedure workflow: (a) subxiphoid placement of the stabilizing port, (b) obtaining direct visualization of the heart, (c) pericardial access with needle, guide wire, then dilator, and sheath, and (d) fixation of the cardiac device

Grahic Jump Location
Fig. 3

In vivo ICD lead implant with a single-incision approach: (a) placement of the stabilizing port, trochar, and needle, (b) pericardial access with needle and guide wire, (c) pericardial access with dilator and sheath, and (d) ICD lead fixation

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