Effects of transmyocardial laser revascularization by using a prototype pulsed CO2 laser on contractility and perfusion of chronically ischemic myocardium in a porcine model
| Autor: | Deborah Bahlman, Kenton W. Gregory, Anthony Furnary, Yasmin Wadia, Michio Kajitani, David J. Sahn, Timothy Irvine, Yoshiki Mori, Michael J. Yessik, Ali Khaki |
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| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Percutaneous Swine medicine.medical_treatment Biomedical Engineering Biophysics Ischemia Myocardial Ischemia Hemodynamics Bioengineering Myocardial Reperfusion Revascularization Coronary Angiography Biomaterials Contractility Internal medicine Occlusion medicine Myocardial Revascularization Animals business.industry Vascular disease General Medicine medicine.disease Myocardial Contraction Disease Models Animal Echocardiography Cardiology Laser Therapy business Perfusion |
| Zdroj: | ASAIO journal (American Society for Artificial Internal Organs : 1992). 46(6) |
| ISSN: | 1058-2916 |
| Popis: | The purpose of this study was to test a new prototype pulsed CO2 laser to be used for transmyocardial laser revascularization (TMR). We wanted to determine whether it can reduce thermal damage and mitigate induced ischemia with improvement in contractile reserve of the heart as evidenced by contrast echocardiography at rest and under dobutamine stress. TMR is an emerging surgical strategy for treatment of myocardial ischemia not amenable to conventional percutaneous or surgical revascularization. Eleven pigs underwent ameroid occluder placement at the origin of the circumflex coronary artery. Six weeks later, occlusion of the circumflex coronary artery was documented. TMR was then carried out on 10 pigs by using a prototype pulsed CO2 laser that delivered 8-12 joules in 1.5 ms with a spot size of 1 mm. Six weeks after TMR, the pigs were restudied. The animals developed significant ischemia after 6 weeks of ameroid occlusion, at rest (p = 0.01) and at peak stress (p = 0.004). Wall motion for the ischemic segments improved significantly 6 weeks after TMR at peak stress (p = 0.02). TMR results in an improvement in wall motion in our model of chronic ischemia and improves wall motion score index more during induced stress than at rest. |
| Databáze: | OpenAIRE |
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