Efficacy of transmyocardial laser revascularization and thoracic sympathectomy for the treatment of refractory angina

Galiñanes, Manuel; Loubani, Mahmoud; Sensky, Penelope R.; Hassouna, A.; Cherryman, G.R.; Leverment, J. N.; Samani, Nilesh J.

doi:10.1016/j.athoracsur.2003.12.032

Cited by 24 publications

(8 citation statements)

References 33 publications

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“…TMR also has been combined with cardiac denervation by thoracic sympathectomy. 926 Numerous single-center and a few multicenter randomized trials have been published that compare TMR with medical therapy for relief of refractory angina. [927][928][929][930] Most have shown better angina relief with TMR but no survival benefit.…”

Section: Fihn Et Al Stable Ischemic Heart Disease: Full Text E411mentioning

confidence: 99%

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

Fihn¹,

Gardin²,

Abrams³

et al. 2012

Circulation

722

441

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Section: Fihn Et Al Stable Ischemic Heart Disease: Full Text E411mentioning

confidence: 99%

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

Fihn¹,

Gardin²,

Abrams³

et al. 2012

Circulation

722

441

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“…This improved perfusion did lead to an improvement in myocardial function, as well. Improved perfusion has not been reported in the Ho:YAG clinical trials, and experimentally no perfusion benefit is seen 90 …”

Section: Mechanisms Of Actionmentioning

confidence: 93%

Transmyocardial Laser Revascularization

Horvath

2008

J Cardiac Surgery

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It has been almost a decade since transmyocardial laser revascularization (TMR) was approved for clinical use in the United States. The safety of TMR was demonstrated initially with nonrandomized studies in which TMR was used as the only treatment for patients with severe angina. TMR efficacy was proven after multiple randomized controlled trials. These revealed significant angina relief compared to maximum medical therapy in patients with diffuse coronary disease not amenable to conventional revascularization. In light of these results, TMR has been used as an adjunct to coronary artery bypass grafting (CABG). By definition, patients treated with this combined therapy have more severe coronary disease and the co morbidities that are associated with end stage athorosclorosis. Combination CABG + TMR has resulted in symptomatic improvement without additional risk. The likely mechanism whereby TMR has provided benefit is the angiogenesis engendered by the laser-tissue interaction. Improved perfusion and concomitant improvement in myocardial function has been observed post TMR. Additional therapies to enhance the angiogenic response include combining TMR with stem cell based treatments which appear to be promising future endeavors.

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“…TMR also has been combined with cardiac denervation by thoracic sympathectomy. 125 Numerous single-center and a few multicenter randomized trials have been published that compare TMR with medical therapy for relief of RA. [126][127][128][129] Most have shown better angina relief with TMR but no survival benefit.…”

Section: Nonpharmacological Therapiesmentioning

confidence: 99%

Newer Therapies for Management of Stable Ischemic Heart Disease With Focus on Refractory Angina

Singh

Arora²

2016

American Journal of Therapeutics

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Ischemic heart disease remains a major public health problem nationally and internationally. Stable ischemic heart disease (SIHD) is one of the clinical manifestations of ischemic heart disease and is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischemia or hypoxia, which are usually inducible by exercise, emotion, or other stress and reproducible-but which may also be occurring spontaneously. Improvements in the treatment of acute coronary syndromes along with increasing prevalence of cardiovascular risk factors, including diabetes and obesity, have led to increasing population of patients with SIHD. A significant number of these continue to have severe angina despite medical management and revascularization procedures performed and may progress to refractory angina. This article reviews the newer therapies in the treatment of SIHD with special focus in treating patients with refractory angina.

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Efficacy of transmyocardial laser revascularization and thoracic sympathectomy for the treatment of refractory angina

Cited by 24 publications

References 33 publications

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

Transmyocardial Laser Revascularization

Newer Therapies for Management of Stable Ischemic Heart Disease With Focus on Refractory Angina

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