I had a small ASD at the time of my first surgery but it needed to be larger. Back then (1967), ASDs had to be created or enlarged the old fashioned way – with a scapel. This was known as the Blalock-Hanlon Procedure, and it was pretty straightforward: cut into an Atrium, look for the ASD, and enlarge it. If you couldn’t find an ASD, make one.
Surgeons don’t perform the Blalock-Hanlon very often these days. (When I read my operative notes just a few months ago I had never even heard of the Blalock-Hanlon, much less knew that I had one!) Today the majority of ASDs are created by a balloon atrial septostomy, which is done by a catheter.
But this new procedure wouldn’t cut the skin at all. Histotripsy is “tissue liquification by ultrasonic wave” – the same technology they use when your uncle has his gallstones crushed. The suffix “-tripsy” is a Greek word that means “to massage” or “to crush.”
This was a small study of only ten dogs. Ultrasound was used to locate an appropriate point for an ASD and then the defect was created by Histotripsy. In nine out of ten cases, the shockwaves created an ASD, and later examination showed that there was “minimal damage” to surrounding cardiac tissue and no damage to the outside of the heart.There is also evidence that Histotripsy could be used for some cardiac ablations.
Much more research needs to be done before this becomes an accepted procedure, but the initial results are promising!
Tags: ASD, Atrial Septial Defect, Atrium, Balloon Atrail Septostomy, Blalock-Hanlon procedure, Catheter, CHD, Congenital Heart Defect, Congenital Heart Disease, Heart, Heart Surgery, Histotripsy, Surgeon