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Figure 3 | Journal of Cardiothoracic Surgery

Figure 3

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

Figure 3

Ultrasonography-guided cell transplantation. To avoid intracardial injections, we developed ultrasonography-guided needle forceps (Nd-U). A: After a double sheath procedure, R-70 and Nd-U were inserted. B: The 23 Gauge needle was extended under ultrasonographic guidance. C: Avoiding any coronary vessels, Nd-U was placed on the lateral wall of the left ventricle. D: An ultrasonographic image was useful in determining anatomical orientations and major vessels at injection sites. E: The needle was extended from the upper right corner of this image. F: Beads were securely injected in the myocardium by confirming the location of the tip of the needle. G: After injections, bead retention in the myocardium was confirmed by a residue of ultrasonographic contrast medium. Be: a mixture of silicon beads and contrast medium; D1: first diagonal branch; Intra: intra ventricle; LAA: left atrial appendage; LV: left ventricle; Ndl: needle; Nd-U as described in Figure‚ÄČ1.

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