B-PO04-207 A NOVEL CATHETER DESIGN PROVIDES CONSIDERABLE DEVIATION OF THE ESOPHAGUS LATERALLY UP TO ≥ 7 CENTIMETERS TO ALLOW PROTECTION DURING THERMAL ABLATION

Abstract

Studies have shown that during thermal ablation, the distance between the esophagus (ESO) and the ablation site within the left atrium is critical with respect to ESO injury. Hence, several tools have been developed to deviate the ESO away from the ablation path. But in most patients, the mean distance of ESO deviation using the available tools is typically only within 2-5 cm. Moreover, there remains doubt whether deviation attempts result in true ESO displacement versus luminal distension. In this proof-of-concept study, we examined the feasibility of ESO deviation in an open and closed-chest cadaver using a novel ESO retracting device (AST). The ESO was deviated using the AST catheter in a cadaver initially with the chest closed under fluoroscopy and also with the chest open under direct visualization. The AST is a 9-Fr, deflectable, orally or trans-nasally inserted ESO retracting catheter which consists of a series of 5 inflatable, elastic balloons with a port to allow injection of contrast medium (total capacity: 60 cc), interrupted by 4 pairs of reference electrodes and thermocouples. Its balloon-based design facilitates gripping of the ESO which enables the operator to maximally displace this structure in the desired direction. Maximal ESO deviation using AST in a closed-chest cadaver resulted in 7.48 cm of lateral deviation (Figure 1A and 1B). This finding was corroborated through direct visualization in an open-chest model which confirmed actual ESO deviation versus luminal distension (Figure 1C). Actual ESO displacement ≥ 7 cm can be achieved using a novel ESO deviation catheter as confirmed in an open- and closed-chest cadaver model.