| Transmyocardial Laser Revascularization. | |
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MedLine Citation:
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PMID: 15023284 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Transmyocardial laser revascularization (TMR) has been performed on over 12,000 patients worldwide. Since 1990, the treatment has provided significant angina relief for symptomatic end-stage coronary disease that is refractory to medical therapy. Seventy-five percent of patients treated with TMR have demonstrated a decrease of two or more angina classes postoperatively. As a result, TMR has provided a significant improvement in quality of life for patients, resulting in fewer hospital admissions and decreased dependency on medications. Two different wavelengths of light, carbon dioxide (CO(2)) and holmium yttrium-aluminum-garnet (Ho:YAG), have been employed. Results obtained using these lasers differ. The CO(2) laser has demonstrated a perfusion benefit as well as long-term improvement in quality of life and angina relief. The Ho:YAG laser has not demonstrated these results. These differences may, in part, explain the failure of percutaneous myocardial laser revascularization. This catheter-based approach was not as successful as TMR due to its partial thickness treatment of the myocardium as well as its use of the Ho:YAG laser. In addition to the patients with end-stage coronary disease who undergo TMR as sole therapy, there are an increasing number of patients who have been treated with a combination of coronary artery bypass grafting and TMR. This provides a more complete revascularization than leaving territories ungrafted. Further enhancement of the angiogenic response seen after TMR may be seen by the addition of gene therapy to TMR treatment. |
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Authors:
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Keith A. Horvath |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Current treatment options in cardiovascular medicine Volume: 6 ISSN: 1534-3189 ISO Abbreviation: Curr Treat Options Cardiovasc Med Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-Mar-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815942 Medline TA: Curr Treat Options Cardiovasc Med Country: - |
Other Details:
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Languages: ENG Pagination: 53-59 Citation Subset: - |
Affiliation:
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Division of Cardiothoracic Surgery, Northwestern University, The Feinberg School of Medicine, 201 E. Huron Street, Galter 10-105, Chicago, IL 60611, USA. khorvath@nmh.org |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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