Document Detail


Acute changes in functional and metabolic parameters following transmyocardial laser revascularization: an experimental study.
MedLine Citation:
PMID:  11173353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Today there is no doubt that angina in patients with diffuse end-stage coronary artery disease can be treated effectively by transmyocardial laser revascularization (TMLR). But until now, the underlying mechanism of TMLR is a matter of debate. The aim of this study was to investigate the immediate changes in functional and metabolic parameters after the creation of TMLR channels. In 12 pigs the local myocardial function (pressure-wall thickness-loops), tissue oxygen partial pressure (PO(2)), and the left ventricular intramyocardial wall pressure (IMP) was investigated simultaneously. The left ventricle was divided into 3 areas. Ischemia was induced in regions 1 and 2 by interrupting the coronary blood flow via the left anterior descending artery for 30 seconds. Region 3 served as non-ischemic control region. Thirty minutes after creation of 15-20 TMR channels in region 1, we repeated the coronary occlusion in regions 1 and 2 followed by measurement of all parameters in the 3 regions. The TMLR-treated region 1 showed a better contractility, a higher tissue PO2 and a higher intramyocardial wall pressure during the post-TMLR coronary occlusion in 8 out of 12 pigs when compared with the pre-TMLR occlusion (p<0.05), whereas the untreated region 2 continued to show severe disturbances in myocardial contractility combined with a lower tissue PO(2) and lower IMP during ischemia. Our results suggest that a blood flow via the laser channels immediately after TMLR is principally possible. However, because the channels seem to occlude in the early postoperative phase, the long-term effects of TMLR are likely to be a result of other mechanisms.
Authors:
T Krabatsch ; D Modersohn ; W Konertz ; R Hetzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  6     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  383-8     Citation Subset:  IM    
Affiliation:
Department of Cardiac, Thoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Female
Heart / physiopathology*
Laser Therapy*
Myocardial Contraction
Myocardial Ischemia / physiopathology*,  surgery*
Myocardial Revascularization / methods*
Oxygen / blood
Swine
Ventricular Function, Left
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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