Perkutane myokardiale Laserrevaskularisation (PMR), ein neues Therapieverfahren für Patienten mit therapierefraktärer Angina pectoris

摘要: In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous angioplasty or bypass surgery, transmyocardial laser revascularization (TMR) often leads improvement of clinical symptoms and increased exercise capacity. One drawback TMR is the need surgical thoracotomy in order gain access epicardial surface heart. Therefore, a catheter-based system has been developed, which allows creation channels into myocardium from left ventricular cavity.Between January 1997 November 1999, this "percutaneous myocardial laser-revascularization" (PMR) was performed 85 at Herzzentrum Leipzig. 43 patients, only one region heart (anterior, lateral, inferior septal) treated PMR; 42 two three regions were session. 12.3±4.3 (range 4-22) channels/region created myocardium.Six months after PMR, majority reported significant (CCS class baseline: 3.3±0.4; 6 months: 1.6±0.9) (p < 0.001) an capacity (baseline: 349±138 s; 470±193 s) 0.05); however, thallium scintigraphy failed show perfusion PMR regions.PMR seems be safe feasible new therapeutic option refractory end-stage disease. The first results indicate capacity; evidence laser-treated still lacking.