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Related Experiment Videos

Transmyocardial Laser Revascularization.

Keith A. Horvath1

  • 1Division of Cardiothoracic Surgery, Northwestern University, The Feinberg School of Medicine, 201 E. Huron Street, Galter 10-105, Chicago, IL 60611, USA. khorvath@nmh.org

Current Treatment Options in Cardiovascular Medicine
|March 17, 2004
PubMed
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Transmyocardial laser revascularization (TMR) offers significant angina relief for end-stage coronary disease. The CO(2) laser shows better long-term results than Ho:YAG, improving quality of life.

Area of Science:

  • Cardiovascular Surgery
  • Medical Technology

Background:

  • Transmyocardial laser revascularization (TMR) treats symptomatic end-stage coronary disease refractory to medical therapy.
  • Over 12,000 patients have undergone TMR worldwide since 1990.
  • TMR improves quality of life, reduces hospital admissions, and decreases medication dependency.

Purpose of the Study:

  • To evaluate the effectiveness of Transmyocardial laser revascularization (TMR) for end-stage coronary disease.
  • To compare the outcomes of different laser wavelengths used in TMR.
  • To explore adjunctive therapies and combinations with TMR.

Main Methods:

  • Analysis of TMR patient outcomes, focusing on angina relief and quality of life.
  • Comparison of results using carbon dioxide (CO(2)) and holmium yttrium-aluminum-garnet (Ho:YAG) lasers.

Related Experiment Videos

  • Review of combined TMR with coronary artery bypass grafting and potential gene therapy enhancement.

    • Main Results:

    • Seventy-five percent of TMR patients experienced a decrease of two or more angina classes.
    • The CO(2) laser demonstrated perfusion benefits and long-term angina relief.
    • The Ho:YAG laser did not yield comparable long-term benefits, potentially explaining percutaneous laser revascularization failures.

    Conclusions:

    • TMR, particularly with the CO(2) laser, provides significant symptomatic relief and improves quality of life in refractory coronary disease.
    • Differences in laser efficacy may explain varying success rates of myocardial revascularization techniques.
    • Combination therapy (TMR with CABG) and gene therapy offer potential for enhanced revascularization.