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Percutaneous method of laser transmyocardial revascularization
1Division of Cardiovascular Medicine, Stanford University School of Medicine, California 94305, USA.
Catheterization and Cardiovascular Diagnosis
|February 1, 1997
Summary
Percutaneous laser transmyocardial revascularization (TMR) using a novel catheter system is feasible. This minimally invasive approach successfully created channels in canine ventricles, similar to open-chest TMR.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Laser Technology
Background:
- Laser transmyocardial revascularization (TMR) aims to perfuse ischemic myocardium by creating channels.
- Current TMR methods involve open thoracotomy, posing significant risks.
- Preliminary studies show promise, but long-term efficacy is under evaluation.
Purpose of the Study:
- To assess the feasibility of a percutaneous approach to TMR.
- To evaluate a novel catheter system for delivering laser energy.
- To create transmyocardial channels via a minimally invasive method.
Main Methods:
- Studies conducted on 15 adult canines.
- Utilized a holmium:YAG laser delivered via a novel catheter system.
- Percutaneous femoral artery approach with fluoroscopic guidance, angiography, and echocardiography.
Main Results:
- Successfully created multiple transmyocardial channels in various ventricular regions.
- Channels were confirmed by ventriculography and histological examination.
- The procedure was well-tolerated, with no observed ventricular dysfunction or arrhythmias.
Conclusions:
- Percutaneous laser transmyocardial revascularization is a feasible procedure.
- This approach creates channels comparable to open-chest TMR.
- Offers a potential minimally invasive alternative for myocardial revascularization.