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Ann Thorac Surg 1998;65:1360-1367
© 1998 The Society of Thoracic Surgeons

Evidence of Vascular Growth Associated With Laser Treatment of Normal Canine Myocardium

Takushi Kohmoto, MDa, Carolyn M. DeRosa, BSa, Noriyoshi Yamamotoa, Peter E. Fisher, MDb, Pedram Failey, BAa, Craig R. Smith, MDa, Daniel Burkhoff, MD, PhDc

a Department of Surgery, Columbia Presbyterian Medical Center, New York City, New York, USA
b Department of Pathology, Columbia Presbyterian Medical Center, New York City, New York, USA
c Department of Medicine, Columbia Presbyterian Medical Center, New York, New York, USA

Accepted for publication January 6, 1998.

Address reprint requests to Dr Burkhoff, Division of Circulatory Physiology, Department of Medicine, Columbia University, 630 W 168th St, New York, NY 10032
e-mail: (db59{at}columbia.edu)

Background. Transmyocardial laser revascularization is a new therapy for patients with refractory angina. Although clinical studies suggest that transmyocardial laser revascularization decreases angina and may improve regional blood flow, the underlying mechanisms are not elucidated. We hypothesized that one mechanism may relate to stimulation of vascular growth in laser-treated regions.

Methods. Transmyocardial laser revascularization channels were made with holmium:yttrium-aluminum garnet or carbon dioxide lasers in eight normal canine hearts; animals were sacrificed 2 to 3 weeks later and examined for vascular density and for evidence of smooth muscle proliferation.

Results. The original channels were infiltrated by granulation tissue with associated vascularity. Vascular growth was stimulated immediately surrounding the channel remnant as evidenced by an increase in the number of vessels (approximately twice that of the control region) and an increase in the number of vascular cells staining positive for markers of cellular proliferation.

Conclusions. Transmyocardial laser revascularization leads to local vascular growth as early as 2 weeks after treatment. It remains to be determined whether this mechanism contributes to increased regional blood flow or to clinical benefits associated with this novel form of therapy.




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