Procedures involving the heart can be complicated and dangerous for the patient, but the use of technologies that can improve visualization of the area can increase the accuracy of the interventions. The heart's close proximity to the wall of the esophagus has led researchers to study the possible benefit of endoscopic ultrasound to visualize the heart and help guide interventions.

This study by researchers at Homerton University Hospital in London focused on the feasibility and safety of trans-esophageal punctures and interventions into the heart and coronary arteries in six pigs and two human patients. Endoscopic ultrasound (EUS) is frequently performed with a scope to visualize and detect abnormalities in the GI tract.

Using EUS to guide them, researchers punctured the myocardium and aortic valve or coronary artery in the six pigs; three received angiography and three received thermal ablation, or clearing of the aortic valve. The repeat puncture of the cardiac walls and injection of contrast to help visualize the tissues showed no complications, nor did the angiography or thermal ablation procedures. EUS-guided fine-needle aspiration, or removal of heart tissue for examination, was conducted in the two human patients, also showing no arrhythmia or other complications.

"Our studies suggest that using a trans-esophageal process to gain access to the heart may be feasible and safe for patients as an alternative to the much longer, indirect route through the femoralis artery in the groin or to open surgery," said Annette Fritscher-Ravens, M.D., of the Homerton University Hospital and lead study author. "This may be of specific interest for patients who have damaged heart muscle after a heart attack and may benefit from the injection of therapies directly into the muscle without another operation."

[Abstract W1277]

Digestive Disease Week� (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 20-25, 2006 in Los Angeles, California. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.

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