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Ann Thorac Surg 1992;53:123-126
© 1992 The Society of Thoracic Surgeons


Articles

Variation in cryolesion penetration due to probe size and tissue thermal conductivity

William L. Holman, MD*, James K. Kirklin, MD, Peter G. Anderson, DVM PhD, Albert D. Pacifico, MD

Division of Cardiothoraoc Surgery and Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA

Accepted for publication August 2, 1991.

* Address reprint requests to Dr Holman, Department of Surgery, University Station, Birmingham, AL 35294.


    Abstract
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 Abstract
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The purpose of this study is to present data comparing the penetration of cryolesions created by various sizes and shapes of cryoprobes in human cadaveric myocardium, fat, and tissue of the central fibrous body. Ten cryolesions were made for each combination of tissue and cryoprobe studied. All cryolesions enlarged most rapidly during the first minute of cryothermia (p < 0.01). Maximal cryothermic penetration into nontrabeculated myocardium was 8.5 ± 0.5 mm (15-mm flat probe) and 6.1 ± 1.0 mm (5-mm small probe). Maximal cryothermic penetration into trabeculated myocardium was 9.4 ± 1.0 mm (10-mm cone-tipped probe) and 7.4 ± 0.5 mm (10-mm flat probe). Maximal cryothermic penetration into fat was 4.7 ± 0.7 mm (15-mm flat probe) and 3.9 ± 0.7 mm (5-mm flat probe). The deeper penetration of cryothermia into myocardium as compared with fat (p < 0.05) is related to the lower thermal conductivity of fat. Maximal cryothermic penetration of the central fibrous body was similar to that of the myocardium with transmural freezing of the central fibrous body after 4.4 ± 0.3 minutes of cryothermia. These data can be used when determining the optimal cryothermic exposure for ablation of arrhythmogenic tissue.


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{star} Supported by grant HL 43213-01A1 from the National Institutes of Health and grant-in-aid A1-G-900001 from the Alabama American Heart Association.

Cryoprobes for this study were contributed by Frigitronics Inc, Shelton, CT.


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  1. Mikat EM, Hackel DB, Harrison L, Gallagher JJ, Wallace AG. Reaction of the myocardium and coronary arteries to cryosurgery Lab Invest 1977;37:632-641.[Medline]
  2. Holman WL, Ikeshita M, Douglas JM, Smith PK, Cox JL. Cardiac cryosurgery: effects of myocardial temperature on cryolesion size Surgery 1983;93:268-272.[Medline]
  3. Markovitz LJ, Frame LH, Josephson ME, Hargrove III WC. Cardiac cryolesions: factors arfecting their size and a means of monitoring their formation Ann Thorac Surg 1988;46:531-535.[Abstract/Free Full Text]
  4. Holman WL, Lease JG, Ikeshita M, Cox JL. Quantitation of cardiac cryolesion size by regional tissue resistance3rd ed. Surg Forum. 34. 1983. pp. 348-350.
  5. Holman WL, Ikeshita M, Douglas Jr JM, Smith PK, Lofland GK, Cox JL. Ventricular cryosurgery: short-term effects on intramural eleclrophysiology Ann Thorac Surg 1983;35:386-393.[Abstract/Free Full Text]
  6. Guiraudon GM. Cryoablation, a versatile tool in arrhythmia surgery [Editorial] Ann Thorac Surg 1987;43:129-130.[Free Full Text]
  7. Ott DA, Garson Jr A, Cooley DA, Smith RT, Moak J. Cryoablative techniques in the treatment of cardiac tachyarrhythmias Ann Thorac Surg 1987;43:138-143.[Abstract/Free Full Text]
  8. Cooper TE, Trezek GJ. On the freezing of tissue J Heat Transfer 1972;94:251-253.
  9. Cooper TE, Trezek GJ. Rate of lesion growth around spherical and cylindrical cryoprobes Cryobiology 1971;7:183-190.
  10. Cooper TE, Trezek GJ. Analytical prediction of the temperature field emanating from a cryogenic surgical cannula Cryobiology 1970;7:79-93.[Medline]
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  15. Holman WL, Ikeshita M, Ungerleider RM, Smith PK, Ideker RE, Cox JL. Cryosurgery of cardiac arrhythmias: acute and chronic effects on coronary arteries Am J Cardiol 1983;51:149-155.[Medline]
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This Article
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