| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;67:1596-1601
© 1999 The Society of Thoracic Surgeons
a Department of Surgery, Baylor College of Medicine and Veterans Affairs Medical Center, Houston, Texas, USA
Address reprint requests to Dr Jones, Department of Surgery, University of Missouri, M580 Health Sciences Center, Columbia, MO 65212
e-mail: jonesjw{at}health.missouri.edu
Presented at the Forty-fifth Annual Meeting of the Southern Thoracic Surgical Association, Orlando, FL, Nov 12–14, 1998.
Background. Transmyocardial revascularization (TMR) surgery uses laser channeling of diseased myocardium to treat ischemia and angina. Rigorous prospective randomized studies have been previously unavailable.
Methods. Forty-three patients were randomized to a medication group and 43 to a group scheduled for TMR surgery and medication. All had advanced cardiac ischemia with CCSA class 3 or 4 angina, took at least 2 cardiac medications at maximum doses, and were ineligible for angioplasty or bypass.
Results. Forty-two of 43 TMR group patients received surgery and were discharged after hospitalizations averaging 3.2 days. Two suffered perioperative MIs, with one death. Four others died within 12 months of surgery, 3 from cardiac events and 1 from pneumonia. Five medical group patients died from cardiac events within 12 months. Three, 6, and 12 month exams showed angina class improvement in TMR patients compared to preoperative values (3.86 ± 0.05 vs 1.71 ± 0.2 P < 0.0001), and to controls at 12 months (3.77 ± 0.07 vs 1.71 ± 0.2, P < 0.0001). Exercise tolerance improved in TMR patients over preoperative values, and was better than medication group scores after 12 months (490 ± 17 sec. vs 294 ± 12 sec., p = 0.0002).
Conclusions. Holmium:YAG laser channeling of the myocardium improves function and reduces angina in advanced cardiac patients who lack alternative therapeutic options.
This article has been cited by other articles:
|
|
 |
|
  K. A. Horvath and Y. Zhou Transmyocardial Laser Revascularization and Extravascular Angiogenetic Techniques to Increase Myocardial Blood Flow Card. Surg. Adult, January 1, 2008; 3(2008): 733 - 752. [Full Text]
|
|
|
|
 |
|
 J. Tasse and R. Arora Transmyocardial Revascularization: Peril and Potential Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2007; 12(1): 44 - 53. [Abstract] [PDF]
|
|
|
|
 |
|
 M. B. Leon, R. Kornowski, W. E. Downey, G. Weisz, D. S. Baim, R. O. Bonow, R. C. Hendel, D. J. Cohen, E. Gervino, R. Laham, et al. A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease J. Am. Coll. Cardiol., November 15, 2005; 46(10): 1812 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. Yang, G. W. Barsness, B. J. Gersh, K. Chandrasekaran, and A. Lerman Current and Future Treatment Strategies for Refractory Angina Mayo Clin. Proc., October 1, 2004; 79(10): 1284 - 1292. [Abstract] [PDF]
|
|
|
|
 |
|
 N. Svorkdal Treatment of Inoperable Coronary Disease and Refractory Angina: Spinal Stimulators, Epidurals, Gene Therapy, Transmyocardial Laser, and Counterpulsation Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2004; 8(1): 43 - 58. [Abstract] [PDF]
|
|
|
|
|
|
E. D. Peterson, P. Kaul, R. G. Kaczmarek, B. G. Hammill, P. W. Armstrong, C. R. Bridges, T. B. Ferguson Jr, and Society of Thoracic Surgeons From controlled trials to clinical practice: monitoring transmyocardial revascularization use and outcomes J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1611 - 1616. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Loubani, D. Chin, J. N. Leverment, and M. Galinanes Mid-term results of combined transmyocardial laser revascularization and coronary artery bypass Ann. Thorac. Surg., October 1, 2003; 76(4): 1163 - 1166. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Saririan and M. J. Eisenberg Myocardial laser revascularization for the treatment of end-stage coronary artery disease J. Am. Coll. Cardiol., January 15, 2003; 41(2): 173 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ruel, R. A. Kelly, and F. W. Sellke Therapeutic Angiogenesis, Transmyocardial Laser Revascularization, and Cell Therapy Card. Surg. Adult, January 1, 2003; 2(2003): 715 - 750. [Full Text]
|
|
|
|
|
|
L. Aaberge, K. Rootwelt, S. Blomhoff, K. Saatvedt, M. Abdelnoor, and K. Forfang Continued symptomatic improvement three to five years after transmyocardial revascularization with co2 laser: A late clinical follow-up of the norwegian randomized trial with transmyocardial revascularization J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1588 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. C. Hughes, S. S. Biswas, B. Yin, D. V. Baklanov, B. H. Annex, R. E. Coleman, T. R. DeGrado, C. K. Landolfo, K. P. Landolfo, and J. E. Lowe A comparison of mechanical and laser transmyocardial revascularization for induction of angiogenesis and arteriogenesis in chronically ischemic myocardium J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1220 - 1228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Lee, K. C. Fischer, and M. R. Moon Reoperative transmyocardial laser revascularization for late recurrent angina Ann. Thorac. Surg., February 1, 2002; 73(2): 650 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Arora, G. M. Hirsch, K. Hirsch, and J. A. Armour Transmyocardial Laser Revascularization Remodels the Intrinsic Cardiac Nervous System in a Chronic Setting Circulation, September 18, 2001; 104 (2009): I-115 - I-120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Pouzet, J.-T. Vilquin, A. A. Hagege, M. Scorsin, E. Messas, M. Fiszman, K. Schwartz, and P. Menasche Factors affecting functional outcome after autologous skeletal myoblast transplantation Ann. Thorac. Surg., March 1, 2001; 71(3): 844 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Schneider, A. Diegeler, R. Krakor, T. Walther, R. Kluge, and F.W. Mohr Transmyocardial laser revascularization with the holmium:YAG laser: loss of symptomatic improvement after 2 years Eur. J. Cardiothorac. Surg., February 1, 2001; 19(2): 164 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.J. Wheatley Cardiothoracic surgery in Europe: politics, pressures and practice Eur. J. Cardiothorac. Surg., December 1, 1999; 16(6): 593 - 601. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
