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Figure 2 | Journal of Cardiothoracic Surgery

Figure 2

From: The effectiveness of rigid pericardial endoscopy for minimally invasive minor surgeries: cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation

Figure 2

Demonstration of cell transplantation with needle with grip (Nd-G). A mixture of silicon beads, indocyanide green, ultrasonographic and fluoroscopic contrast medium was injected into the myocardium by Nd-G. A: Two sheaths were inserted into the pericardial space, Sh-S with R-70 and Sh-L with Nd-G. Coronary vessels such as the first diagonal branch (D1) were clearly visualized to avoid injuries. B: Nd-G was inserted through Sh-L and placed at the puncture site while avoiding coronary vessels. C: Injections were performed 20 times (white arrows). Intraventricular injections due to strong motion artifacts caused a slight hemorrhage (Bld) that spontaneously stopped without hemodynamic change. Macroscopic evaluation (D), a cross section of injected sites (E), and a cross section with fluorescence filter (F) showed that the transmural injection was successfully performed in the anterolateral wall of the left ventricle. Bld: blood; LAA: left atrial appendage; LAD: left anterior descending artery; LV: left ventricle; RAA: right atrial appendage; RV: right ventricle; Wire: a guide wire; Sh-L, Sh-S, Nd-G; as described in Figure‚ÄČ1.

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