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Ann Thorac Surg 2000;69:655-662
© 2000 The Society of Thoracic Surgeons

Current Reviews

Myocardial laser revascularization: the controversy and the data

Charles R. Bridges, MD, ScDa

a Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA

Address reprint requests to Dr Bridges, Department of Surgery, Hospital of the University of Pennsylvania, 4 Silverstein, 3400 Spruce St, Philadelphia, PA 19104
e-mail: cbridges{at}mail.med.upenn.edu

The clinical and experimental data relevant to the theoretical mechanisms and clinical results of laser myocardial revascularization are reviewed. Both transmyocardial and percutaneous approaches are considered. Both types result in a reduction in anginal symptoms in patients refractory to conventional therapy and are likely to act through common pathways. The proximate mechanisms for the transmyocardial revascularization effect most likely relate to myocardial inflammation, secondary stimulation of growth factors, and denervation of the myocardium.




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