TRANSMYOCARDIAL LASER REVASCULARIZATION
Identifieur interne : 001197 ( Main/Exploration ); précédent : 001196; suivant : 001198TRANSMYOCARDIAL LASER REVASCULARIZATION
Auteurs : Keith A. HorvathSource :
- Journal of cardiac surgery [ 0886-0440 ] ; 2008.
Abstract
It has been almost a decade since transmyocardial laser revascularization (TMR) was approved for clinical use in the United States. The safety of TMR was demonstrated initially with non-randomized studies in which TMR was used as the only treatment for patients with severe angina. TMR efficacy was proven after multiple randomized controlled trials. These revealed significant angina relief compared to maximum medical therapy in patients with diffuse coronary disease not amenable to conventional revascularization. In light of these results, TMR has been used as an adjunct to coronary artery bypass grafting (CABG). By definition, patients treated with this combined therapy have more severe coronary disease and the co morbidities that are associated with end stage athorosclorosis. Combination CABG + TMR has resulted in symptomatic improvement without additional risk. The likely mechanism whereby TMR has provided benefit is the angiogenesis engendered by the laser-tissue interaction. Improved perfusion and concomitant improvement in myocardial function has been observed post TMR. Additional therapies to enhance the angiogenic response include combining TMR with stem cell based treatments which appear to be promising future endeavors.
Url:
DOI: 10.1111/j.1540-8191.2008.00579.x
PubMed: 18435649
PubMed Central: 4224272
Affiliations:
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Le document en format XML
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