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Transmyocardial Laser Revascularization

1999; Massachusetts Medical Society; Volume: 341; Issue: 14 Linguagem: Inglês

10.1056/nejm199909303411410

1533-4406

Richard A. Lange, L.David Hillis,

Pain Management and Treatment

To perform transmyocardial laser revascularization, the surgeon exposes the beating heart through a lateral thoracotomy, places a laser (carbon dioxide or holmium) on the epicardial surface of the left ventricle, and applies sufficient energy to create small channels from the epicardial to the endocardial surfaces. During a typical procedure, 10 to 50 such channels are created. Initially, these small, laser-created transmyocardial channels were thought to improve the perfusion of ischemic myocardium by providing it with direct access to oxygen-rich left ventricular blood, but it was subsequently found that the channels quickly occlude after the procedure.1 Nonetheless, initial observational studies of . . .