Comparative Cardiac Anatomy and Transmyocardial Laser Revascularization

Abstract

Comparative cardiac anatomy related to the analysis of the initial clinical experience of transmyocardial laser revascularization (tmlr) in patients with severe diffuse coronary artery disease.methods20 patients were submitted to tmlr at the heart institute (incor), university of são paulo medical school, brazil, isolated or in association with conventional coronary artery bypass graft (cabg). all patients had severe diffuse coronary artery disease, with angina functional class iii/iv (canadian cardiovascular society score) unresponsive to medical therapy. fourteen patients were submitted to tmlr as the sole therapy, whereas 6 underwent concomitant cabg. fifty per cent of the patients had either been previously submitted to a cabg or to a percutaneous transluminal coronary angioplasty (ptca). mean age was 60 years, ranging from 45 to 74 years.resultsall patients had three‐vessel disease, with normal or mildly impaired left ventricular global function. follow‐up ranged from 1 to 13 months (mean 6.6 months), with no postoperative short or long term mortality. there was significant symptom improvement after the procedure, with 85% of the patients free of angina, and the remaining 15 % of the patients showing improvement in functional class, as well as in exercise tolerance.