Transmyocardial laser revascularization with the CO2 laser: one year results of a randomized, controlled trial

Transmyocardial laser revascularization (TMR) was compared to continued medical management in 198 patients with symptomatic end-stage coronary artery disease in a 1:1 randomized prospective study. Angina class, quality of life, and myocardial perfusion significantly improved following TMR over a 12-month period of follow-up. Continued medical management was associated with a higher incidence of unstable anginal episodes, repeat hospitalizations, worsening anginal class and myocardial perfusion. This study demonstrates the superiority of TMR over medical management in the treatment of chronic stable angina. With appropriate patient selection and perioperative management, TMR with the CO2 laser is associated with a very low operative risk.