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Transmyocardial laser revascularization. Personal experience

Sansone, F ; Actis Dato, G M ; Zingarelli, E ; Punta, G ; Parisi, F ; Forsennati, P G ; Flocco, R ; Bardi, G L ; Del Ponte, S ; Casabona, R

Il Giornale di chirurgia, 2011-11, Vol.32 (11-12), p.464-466 [Periódico revisado por pares]

Italy

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Título:
Transmyocardial laser revascularization. Personal experience
Autor: Sansone, F ; Actis Dato, G M ; Zingarelli, E ; Punta, G ; Parisi, F ; Forsennati, P G ; Flocco, R ; Bardi, G L ; Del Ponte, S ; Casabona, R
Assuntos: Aged ; Angina Pectoris - surgery ; Angioplasty, Balloon, Coronary ; Arrhythmias, Cardiac - prevention & control ; Coronary Artery Bypass ; Female ; Humans ; Intra-Aortic Balloon Pumping ; Intraoperative Care ; Intraoperative Complications - prevention & control ; Lidocaine - therapeutic use ; Male ; Middle Aged ; Myocardial Infarction - surgery ; Myocardial Infarction - therapy ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors ; Transmyocardial Laser Revascularization - methods ; Transmyocardial Laser Revascularization - statistics & numerical data ; Treatment Outcome
É parte de: Il Giornale di chirurgia, 2011-11, Vol.32 (11-12), p.464-466
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: Indirect revascularization is a therapeutic approach in case of severe angina not suitable for percutaneous or surgical revascularization. Transmyocardial revascularization (TMR) is one of the techniques used for indirect revascularization and it allows to create transmyocardial channels by a laser energy bundle delivered on left ventricular epicardial surface. Benefits of the procedure are related mainly to the angiogenesis caused by inflammation and secondly to the destruction of the nervous fibers of the heart. From September 1996 up to July 1997, 14 patients (9 males - 66.7%, mean age 64.8±7.9 years) underwent TMR. All patients referred angina at rest; Canadian Angina Class was IV in 7 patients (58.3%), III in 5 (41.7%). Before the enrollment, coronarography was routinely performed to find out the feasibility of Coronary Artery Bypass Graft (CABG): 13 patients (91,6%) had coronary arteries lesions not suitable for direct revascularization; this condition was limited only to postero-lateral area in one patient submitted to combined TMR + CABG procedures. Mean discharge time was 3,2±1,3 days after surgery. All patients were discharged in good clinical conditions. Perfusion thallium scintigraphy was performed in 7 patients at a mean follow-up of 4±2 months, showing in all but one an improvement of perfusion defects. Moreover an exercise treadmill improvement was observed in the same patients and all of them are in good clinical conditions, with significantly reduced use of active drugs. CONCLUSION; Our experience confirms that TMR is a safe and feasible procedure and it offers a therapeutic solution in case of untreatable angina. Moreover, it could be a hybrid approach for patients undergoing CABGs in case of absence of vessels suitable for surgical approach in limited areas of the heart.
Editor: Italy
Idioma: Inglês

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Transmyocardial laser revascularization. Personal experience

Sansone, F ; Actis Dato, G M ; Zingarelli, E ; Punta, G ; Parisi, F ; Forsennati, P G ; Flocco, R ; Bardi, G L ; Del Ponte, S ; Casabona, R

Italy

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