Myocardial Revascularization by CO₂ Laser

Abstract

An original method of myocardial revascularization using CO₂ laser has been studied in a pig model with acute myocardial infarction. Transparietal channels were created by myocardial vaporization, using a CO₂ laser beam. A comparative evaluation was made against a control group using as parameters survival rate, ECG changes, anatomopathologic findings, and angiographic studies. With the exception of favorable changes in the ECG there was no other evidence of improved regional perfusion. No evidence of long-term patency of the transmyocardial channels could be demonstrated by angiographic and histologic studies.

Transmyocardial Laser Revascularization with the Holmium:YAG Laser Does Not Improve Myocardial Perfusion in the Acutely Ischemic Heart: an Experimental Study Measuring Myocardial Perfusion by a Thermal Imaging Camera

“…The rapid change of regional myocard ial blood now after occlusion of a coro nary arte ry was reported by Shaper et al 121 using rad iolabeled microsph eres. Adachi et al 13 1showed in an open-chested dog model with acute ischemia the significant correlation betwee n regional myocardial blood now measured wi th radiolabe led micro spheres and myocardia l surface temperature. La ter.…”

Myocardial scarring after transmyocardial laser revascularization: A potential mechanism of clinical improvement?

“…It is worth emphasizing to note that studies claiming a positive effect of TMLR in dogs did not measure blood flow [9,10], whereas those that found no positive effect did measure collateral flow [11][12][13][14][15][16], which is a crucial determinant of infarct size in canine studies. Moreover, in our study the infarctions in the TMLR-MI group were transmural, underlining the absence of protection provided by channels in this model.…”

Transmyocardial laser revascularisation in acutely ischaemic myocardium1

“…Whether the model was a dog [8,9] or a sheep [10], none of these studies did take collateral blood flow into consideration. Further supporting this hypothesis, there is substantial evidence that laser-made channels cannot provide blood flow to ischaemic myocardium, either in dog hearts, when collateral flow was measured [11][12][13][14] or in pig hearts which have little collateral circulation [15].…”