Transmyocardial revascularization: the fate of myocardial channels

Attempted cardiac revascularization through laser-made channels has gained considerable recent notoriety. Although the treatment reduces angina, its ability to enhance perfusion is unclear, and the mechanism of action unknown. The fate of the channels appears an obvious place to look for insight. Therefore, this review focuses on temporal and spatial changes in channel morphology. An appreciation of the natural history of the channels not only has potential to elucidate mechanisms, but also to provide the basis for optimization of channel-making.