Transmyocardial laser revascularization. Anatomic evidence of long-term channel patency.

摘要: Abstract Transmyocardial laser revascularization, a new surgical technique, is being tested in patients with chronic obstructive coronary artery disease that refractory to conventional revascularization techniques and maximal medical therapy. During the operation, which performed on beating heart through left thoracotomy, high-energy CO2 used bore transmural channels (1 mm diameter) into ventricle. Each pulse delivered during end diastole transects within 10 60 msec. The operation based theory blood will flow directly from ventricle then myocardial vascular plexus. Restoring perfusion should alleviate ischemia potentially viable myocardium improve ventricular function. Recently, one of our died 3 months after transmyocardial causes unrelated operation. Histologic analysis enabled us obtain, for 1st time, anatomic evidence patent channels. Routine staining cardiac tissue hematoxylin eosin revealed multiple channels, running perpendicular interconnecting native vasculature. Although reactive fibrous scar had caused narrowing original tract, endothelialized they contained red cells. These findings suggest were functional. We report this interesting case briefly discuss physiologic phenomena involved establishing camerosinusoidal by use revascularization.