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Transmyocardial laser revascularization 12 years later
Stefano Pratali1, Francesca Chiaramonti, Aldo Milano
1Section of Cardiac Surgery, Cardiac Thoracic and Vascular Department, University of Pisa Medical School, Pisa, Italy.
Interactive Cardiovascular and Thoracic Surgery
|July 17, 2010
Summary
Long-term follow-up of transmyocardial laser revascularization (TMLR) shows questionable survival rates. TMLR may be more effective when combined with other procedures or growth factors.
Area of Science:
- Cardiology
- Minimally Invasive Cardiac Surgery
Background:
- Transmyocardial laser revascularization (TMLR) is a therapeutic option for refractory angina.
- Long-term outcomes of TMLR as an isolated procedure require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy and survival rates of patients who underwent TMLR between 1995 and 1999.
Main Methods:
- Retrospective analysis of 34 patients who underwent TMLR.
- Assessment of actuarial survival, freedom from cardiac death, and freedom from major adverse cardiac events at 12 years.
- Evaluation of angina class in surviving patients.
Main Results:
- Actuarial survival at 12 years was 24%±8%.
- Actuarial freedom from cardiac deaths was 36%±10%.
- Actuarial freedom from major adverse cardiac events was 13%±8%.
- Mean angina class among survivors was 2.7±0.6.
Conclusions:
- The use of TMLR as an isolated procedure yields questionable long-term results.
- TMLR might offer improved outcomes when combined with myocardial revascularization or used to deliver growth factors.
