Abstract
Since 1980's we have investigated laser works concerning to 3 fields of cardiovascular surgery. These works are as follows. That is, (1) Transmyocardial revascularization, (2) Laser vascular anastomosis, (3) Laser angioplasty. (1) Transmyocardial revascularization (TMR): This method is applied only for the patient for whom coronary artery bypass grafting (CABG) can not be carried out, because of small and diffuse stenoses of the coronary arteries. By this procedure arterial blood from the left ventricular cavity is supplied into the ischemic myocardium through the newly created myocardial channel by CO2 laser (output more than 80W, irradiation time 0.2 sec ). The new channel in the myocardium was opened for 3 years. And then, clinical application was done in November 12, 1985. This is a first clinical successful case in Japan. (2) Laser vascular anastomosis: Low power CO2 laser was used for this study. Optimal conditions were 20-40mW in output and 6-12 sec/mm in irradiation. First clinical application in the world was successfully performed in January 21, 1985. (3) Laser angioplasty: Based on excellent experimental results clinical application by Argon laser was done for 98 patients with intermittent claudication and stenosis more than 75% angiographycally. Cumulative patency rate in the follow up to 96 months was 87% in the stenotic lesions and 71% in the occlusive lesions.
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