Abstract
Objectives
To evaluate the rate of short-term complications associated with microwave ablation of lung tumors located near the heart.
Methods
This HIPAA-compliant study was performed with a waiver for informed consent. Patients who underwent microwave ablation of lung tumors located 10 mm or less from the heart were identified by retrospective chart review. Both primary and metastatic tumors were included. Only tumors directly adjacent to one of the four cardiac chambers were included. All patients were treated in a single session using CT guidance with continuous electrocardiographic monitoring. Rates of new-onset arrhythmia and myocardial infarction (MI) within 90 days of the procedure were quantified, and evidence of cardiac or pericardiac injury was assessed for using post-ablation contrast-enhanced chest CT, electrocardiography (EKG), and—when available—echocardiography. Complications were graded using the Common Terminology Criteria for Adverse Events (CTCAE) system.
Results
Ten patients (four males, six females; mean age 73.1 ± 9.5 years) met all inclusion criteria. Mean tumor distance from the heart was 3 mm (range, 0–6 mm). New-onset arrhythmia was not observed during or following any of the microwave ablation treatments, and there were no documented 90-day MI events. CTCAE Grade 1 complications were observed by CT in eight patients, most commonly mild focal pericardial thickening. EKG and echocardiography were normal in all patients. No major complications (CTCAE Grade 3 or greater) were observed.
Conclusions
Microwave ablation of lung tumors located 10 mm or less from the heart appears to have low associated short-term morbidity and may be appropriate in selected patients.
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Aaron W. P. Maxwell, M.D., and Terrance T. Healey, M.D., declare no conflict of interest. Damian E. Dupuy, M.D., received fundings from Medtronic, Galil Medical, and royalties from Springer-Verlag and UpToDate. He is one of the Board of Directors of Perseon Medical.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Maxwell, A.W.P., Healey, T.T. & Dupuy, D.E. Microwave Ablation of Lung Tumors Near the Heart: A Retrospective Review of Short-Term Procedural Safety in Ten Patients. Cardiovasc Intervent Radiol 40, 1401–1407 (2017). https://doi.org/10.1007/s00270-017-1660-y
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DOI: https://doi.org/10.1007/s00270-017-1660-y