590 results match your criteria Transmyocardial Laser Revascularization


Treatment of End-Stage Coronary Artery Disease with the Mode of Combination of Disease and Syndrome: A Case Report.

Chin J Integr Med 2021 Apr 24. Epub 2021 Apr 24.

Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, National Clinical Research Center for Chinese Medicine Cardiology, Beijing, 100091, China.

Conclusion: Although cardiovascular mortality in end-stage CAD patient has declined due to improved secondary prevention, but new therapeutic strategies remains required. Transmyocardial laser revascularization, cardiac shock wave therapy, gene therapeutics and heart transplantation have now been accepted treatments for end-stage CAD, but remains lack of adequate clinical evidence. This case report showed that integrative medicine can awaken hibernation myocardium and reduction in symptoms of angina. Read More

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Management of refractory angina: an update.

Eur Heart J 2021 Jan;42(3):269-283

National Heart and Lung Institute, Imperial College, Guy Scadding Building, Dovehouse Street, London SW3 6LY, UK.

Despite the use of anti-anginal drugs and/or percutaneous coronary interventions (PCI) or coronary artery bypass grafting, the proportion of patients with coronary artery disease who have daily or weekly angina ranges from 2% to 24%. Refractory angina refers to long-lasting symptoms (for >3 months) due to established reversible ischaemia, which cannot be controlled by escalating medical therapy with the use of 2nd- and 3rd-line pharmacological agents, bypass grafting, or stenting. While there is uncertain prognostic benefit, the treatment of refractory angina is important to improve the quality of life of the patients affected. Read More

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January 2021

Long-term results of isolated transmyocardial laser revascularization in combination with the intramyocardial autologous bone marrow stem cells injection.

Lasers Med Sci 2020 Jul 4;35(5):1111-1117. Epub 2019 Dec 4.

Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russia.

To evaluate the long-term results of TMLR using a CO laser in combination with intramyocardial injection of ABMSC as an isolated procedure in patients with the end-stage coronary artery disease, the study included 20 patients (90% male), with a mean age of 58.4 ± 8.7 years. Read More

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Refractory Angina: the Current State of Mechanical Therapies.

Curr Cardiol Rep 2019 04 22;21(6):46. Epub 2019 Apr 22.

Texas Tech University Health Sciences Center, El Paso, TX, USA.

Purpose Of Review: Refractory angina (RA), which is characterized by tissue ischemia along with neurological, mitochondrial, and psychogenic dysfunction, is becoming a major cause of morbidity in patients with advanced coronary artery disease. In this review, we discuss in detail the invasive mechanical non-cell therapy-based options, the evidence behind these therapies, and future trends.

Recent Findings: There is extensive ongoing research in the areas of spinal-cord stimulation, transmyocardial laser revascularization, sympathectomy, angiogenesis, and other non-cell-based therapies to explore the best therapy for refractory angina. Read More

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Transmyocardial revascularization (TMR): current status and future directions.

Indian J Thorac Cardiovasc Surg 2018 Dec 8;34(Suppl 3):330-339. Epub 2018 Oct 8.

Saint Luke's Mid America Heart Institute, 4320 Wornall Rd, Medical Plaza II, Suite 50, Kansas City, MO 64111 USA.

Purpose: Cardiac surgeons are increasingly faced with a more complex patient who has developed a pattern of diffuse coronary artery disease (CAD), which is refractory to medical, percutaneous, and surgical interventions. This paper will review the clinical science surrounding transmyocardial revascularization (TMR) with an emphasis on the results from randomized controlled trials.

Methods: Randomized controlled trials which evaluated TMR used as sole therapy and when combined with coronary artery bypass grafting were reviewed. Read More

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December 2018

Increased risks for random errors are common in outcomes graded as high certainty of evidence.

J Clin Epidemiol 2019 02 19;106:50-59. Epub 2018 Oct 19.

Copenhagen Trial Unit; Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Objectives: The aim of article was to assess the risk for random errors in outcomes graded as high certainty of evidence (CoE).

Study Design And Setting: We randomly selected 100 Cochrane reviews with dichotomous outcomes rated as high CoE using Grading of Recommendations Assessment, Development, and Evaluation. To detect increased risks for random errors, two investigators independently conducted trial sequential analysis using conventional thresholds for type I (α = 0. Read More

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February 2019

Midterm outcomes of transmyocardial laser revascularization with intramyocardial injection of adipose derived stromal cells for severe refractory angina.

Postepy Kardiol Interwencyjnej 2018 19;14(2):176-182. Epub 2018 Jun 19.

Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.

Introduction: Refractory angina has limited effective therapeutic options and often contributes to frequent hospitalizations, morbidity and impaired quality of life.

Aim: We sought to examine midterm results of a bio-interventional therapy combining transmyocardial laser revascularization (TMLR) and intramyocardial injection of adipose derived stem cells (ADSC) in patients with refractory angina not amenable to percutaneous or surgical revascularization.

Material And Methods: We included 15 patients with severe refractory angina and anterior wall ischemia who were ineligible for revascularization strategies. Read More

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Ten-year follow-up after combined coronary artery bypass grafting and transmyocardial laser revascularization in patients with disseminated coronary atherosclerosis.

Lasers Med Sci 2018 Sep 7;33(7):1527-1535. Epub 2018 May 7.

Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Jagiellonian University, ul. Pradnika 80, 31-202, Cracow, Poland.

Coronary artery disease involving heavily calcified lesions has been associated with worse short- and long-term outcomes including increased mortality. This paper aims to evaluate long-term survival benefit when CABG + transmyocardial laser revascularization (TMLR) are performed on the hearts of patients with disseminated coronary atherosclerosis (DCA). This novel retrospective study was conducted between 1997 and 2002 and followed 86 patients with ischemic heart disease and severe DCA who underwent TMLR using a Holmium:YAG laser and/or CABG. Read More

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September 2018

Mechanical Therapies for Refractory Angina: The Current Evidence.

Am J Ther 2018 May/Jun;25(3):e369-e374

Department of Internal Medicine, Maimonides Medical Center, New York City, NY.

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September 2018

Video-assisted thoracoscopic surgery approach for transmyocardial laser revascularization.

Interact Cardiovasc Thorac Surg 2017 11;25(5):848-849

Division of Cardiothoracic Surgery, Department of Surgery, Carver College of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Transmyocardial laser revascularization is an established therapy for refractory coronary artery disease. However, utilization of the technology is not as widespread as expected. This is despite the fact that the efficacy of the technology has been established in multiple prospective randomized trials. Read More

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November 2017

Clinical outcomes meta-analysis: measuring subendocardial perfusion and efficacy of transmyocardial laser revascularization with nuclear imaging.

J Cardiothorac Surg 2017 May 19;12(1):37. Epub 2017 May 19.

Department of Medical Pharmacology, University of Arizona College of Medicine, Tucson, AZ, USA.

Introduction: Randomized and nonrandomized clinical trials have tried to assess whether or not TMR patients experience an increase in myocardial perfusion. However there have been inconsistencies reported in the literature due to the use of different nuclear imaging modalities to test this metric. The primary purpose of this meta-analysis was to determine whether SPECT, MUGA and PET scans demonstrate changes in myocardial perfusion between lased and non-lased subjects and whether laser type affects myocardial perfusion. Read More

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Long-term follow-up after Holmium:YAG laser revascularization combined with autologous bone marrow derived stem cells implantation.

Przegl Lek 2017;74(3):91-5

Background: Coronary artery disease is a major cause of death worldwide. Despite different standard revascularization options, significant number of patients remains not suitable for any treatment. The aim of the study was to evaluate long-term outcome of patients with diffuse coronary artery disease, treated with autologous stem cells injections combined with transmyocardial laser revascularization. Read More

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Remodeling an infarcted heart: novel hybrid treatment with transmyocardial revascularization and stem cell therapy.

Springerplus 2016 16;5(1):738. Epub 2016 Jun 16.

Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, P.O. Box 245071, 1501N. Campbell Avenue, Tucson, AZ 85724-5071 USA ; Department of Physiological Sciences, University of Arizona College of Medicine, Tucson, AZ USA ; Banner University Medical Center, 1501N. Campbell Avenue, Room 4302A, Tucson, AZ 85724 USA ; Medical Research Building, 1656 E. Mabel St, Rm 120, Tucson, AZ USA.

Transmyocardial revascularization (TMR) has emerged as an additional therapeutic option for patients suffering from diffuse coronary artery disease (CAD), providing immediate angina relief. Recent studies indicate that the volume of surgical cases being performed with TMR have been steadily rising, utilizing TMR as an adjunctive therapy. Therefore the purpose of this review is to provide an up-to-date appreciation of the current state of TMR and its future developmental directions on CAD treatment. Read More

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Does surgical sympathectomy improve clinical outcomes in patients with refractory angina pectoris?

Interact Cardiovasc Thorac Surg 2016 Apr 18;22(4):488-92. Epub 2016 Jan 18.

Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In patients with angina pectoris refractory to medical therapy, does surgical sympathectomy improve clinical outcomes? A total of 528 papers were identified using the search protocol described, of which 6 represented the best evidence to answer the clinical question. There were 5 case series and 1 prospective cohort study. Read More

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Total arterial myocardial revascularization in patients over 70 years old - a new trend in coronary surgery in elderly.

Przegl Lek 2016;73(11):813-5

Introduction: In modern society, civilization has extended the life expectancy of developed nations. The demographic analysis of Eurostat (European Statistical Office) predicts the increase of the population over 70 years old in Western Europe from 15.2% reported in 1995 to 19. Read More

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Alternative Therapy for Medically Refractory Angina: Enhanced External Counterpulsation and Transmyocardial Laser Revascularization.

Authors:
Ozlem Soran

Heart Fail Clin 2016 Jan;12(1):107-16

Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Scaife Hall S-623, Pittsburgh, PA 15213, USA. Electronic address:

Medically refractory angina pectoris (RAP) is defined by presence of severe angina with objective evidence of ischemia and failure to relieve symptoms with coronary revascularization. Medication and invasive revascularization are the most common approaches for treating coronary artery disease (CAD). Although symptoms are eliminated or alleviated by these invasive approaches, the disease and its causes are present after treatment. Read More

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January 2016

Redo coronary artery bypass grafting: on-pump and off-pump coronary artery bypass grafting revascularization techniques.

Chin Med Sci J 2015 Mar;30(1):28-33

Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China.

Objective: To analyze the short-term outcomes of redo coronary artery bypass grafting (CABG) using on-pump and off-pump CABG techniques.

Methods: From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique (redo-ONCAB group) and 40 underwent off-pump CABG technique (redo-OPCAB group). Read More

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Transmyocardial laser revascularization versus medical therapy for refractory angina.

Cochrane Database Syst Rev 2015 Feb 27(2):CD003712. Epub 2015 Feb 27.

Public Health Unit, Primary Care District. IBIS-CIBERESP, Avda Jerez s/n, Antiguo Hospital Militar, Sevilla, Sevilla, Spain, 41014.

Background: This is an update of a review previously published in 2009. Chronic angina and advanced forms of coronary disease are increasingly more frequent. In spite of the improvement in the efficacy of available revascularization treatments, a subgroup of patients continue suffering from refractory angina. Read More

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February 2015

Transmyocardial revascularization devices: technology update.

Med Devices (Auckl) 2015 18;8:11-9. Epub 2014 Dec 18.

Cardiothoracic Surgery Research Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

Transmyocardial laser revascularization (TMR) emerged as treatment modality for patients with diffuse coronary artery disease not amendable to percutaneous or surgical revascularization. The procedure entails the creation of laser channels within ischemic myocardium in an effort to better perfuse these areas. Currently, two laser devices are approved by the US Food and Drug Administration for TMR - holmium:yttrium-aluminum-garnet and CO2. Read More

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January 2015

Transmyocardial Revascularization Enhances Bone Marrow Stem Cell Engraftment in Infarcted Hearts Through SCF-C-kit and SDF-1-CXCR4 Signaling Axes.

Stem Cell Rev Rep 2015 Apr;11(2):332-46

Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.

Background: We investigated the roles of stem cell factor (SCF)-c-kit and stromal derived factor-1 (SDF-1)-CXCR4 signaling axes in transmyocardial revascularization (TMR)-enhanced engraftment of transplanted bone marrow stem cells (BMSCs) in infarcted hearts.

Methods: 3 weeks after LAD ligation, female Lewis rats underwent 10-channel needle-TMR, followed by daily IV injections of 1 million male donor BMSC for 5 days, either wild type (WT) or with knockdown (K/D) of c-kit or CXCR4, accomplished via a shRNA + plasmid in a lentiviral vector (N = 6/group).

Results: In our rat infarct model, 3 days after last BMSC injection, the number of BMSCs that homed into infarct was affected by both TMR and donor cell type, with greater BMSC engraftment with TMR and with WT BMSC (TMR, cell type, and interaction, P < 0. Read More

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Robotically assisted, completely endoscopic transmyocardial revascularization is feasible.

Innovations (Phila) 2014 Sep-Oct;9(5):379-82; discussion 382

From the *Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL USA; †St. Joseph's Hospital, Atlanta, GA USA; ‡Akron City Hospital, Akron, OH USA; and §The International Centre for Robotic Surgery, New Delhi, India.

Objective: The purpose of this study was to assess the feasibility of an endoscopic, optical-fiber-based, laser delivery system (LDS) developed to perform sole-therapy transmyocardial revascularization (TMR) in a totally endoscopic, robotically assisted operation.

Methods: Forty-two patients were enrolled in a multicenter, prospective, single-arm clinical trial conducted at four US centers between 2005 and 2007. Transmyocardial revascularization was performed completely endoscopically with robotic assistance, introducing the Holmium:Yttrium aluminum garnet (YAG) LDS via a 5-mm port. Read More

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Alternative therapy for medically refractory angina: enhanced external counterpulsation and transmyocardial laser revascularization.

Authors:
Ozlem Soran

Cardiol Clin 2014 Aug;32(3):429-38

Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Scaife Hall S-623, Pittsburgh, PA 15213, USA. Electronic address:

Medically refractory angina pectoris (RAP) is defined by presence of severe angina with objective evidence of ischemia and failure to relieve symptoms with coronary revascularization. Medication and invasive revascularization are the most common approaches for treating coronary artery disease (CAD). Although symptoms are eliminated or alleviated by these invasive approaches, the disease and its causes are present after treatment. Read More

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Combined use of transmyocardial laser revascularization and endothelial progenitor cells enhances neovascularization and regional contractility in a canine model of ischemic hearts.

J Huazhong Univ Sci Technolog Med Sci 2014 Apr 8;34(2):220-224. Epub 2014 Apr 8.

Department of Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

The purpose of this study was to determine the combined effect of transmyocardial laser revascularization (TMLR) and the implantation of endothelial progenitor cells (EPCs) on cardiac function of ischemic hearts in canines. The left anterior descending artery (LAD) was occluded to establish the canine model of acute myocardial infarct (AMI). Four weeks later, the animals were randomly divided into four groups: TMLR group, in which transmyocardial laser-induced channels were established at the ischemic region; EPCs+TMLR group, in which EPCs were locally transplanted into laser-induced channels at the ischemic region; EPCs group, in which the EPCs were injected into the ischemic region; control group, in which the AMI animals received neither TMLR nor EPCs. Read More

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[Ischemic heart disease: from traditional surgery and standard therapy to cellular cardiomyoplasty and laser revascularization].

Lik Sprava 2013 Mar(2):3-13

Myocardial ischemia and cardiac dysfunction have been known to follow ischemic heart disease cell therapy and laser revascularization harbors a promising potential for vascular and cardiac reparation, which is corroborated by adequate preclinical evidence. In this review we present an analysis research of mesenchymal stem cells transplantation and transmyocardial laser revascularization for myocardial repair. Read More

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Transesophageal echocardiography for transmyocardial laser revascularization.

Anesth Analg 2014 Mar;118(3):512-5

From the Departments of *Anesthesiology and Perioperative Medicine and †Surgery, Georgia Regents University, Augusta, Georgia.

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Improved myocardial perfusion after transmyocardial laser revascularization in a patient with microvascular coronary artery disease.

SAGE Open Med Case Rep 2014 4;2:2050313X14526873. Epub 2014 Mar 4.

Heart Institute, Good Samaritan Hospital, Los Angeles, CA, USA; Department of Cardiology, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.

We report the case of a 59-year-old woman who presented with symptoms of angina that was refractory to medical management. Although her cardiac catheterization revealed microvascular coronary artery disease, her symptoms were refractory to optimal medical management that included ranolazine. After undergoing transmyocardial revascularization, her myocardial ischemia completely resolved and her symptoms dramatically improved. Read More

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The combined use of transmyocardial laser revascularisation and intramyocardial injection of bone-marrow derived stem cells in patients with end-stage coronary artery disease: one year follow-up.

Kardiol Pol 2013 ;71(5):485-92

Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow, Poland.

Background: There are a growing number of patients with end-stage coronary artery disease (CAD) and refractory angina. Angiogenesis may be induced by intramyocardial injection of autologous bone marrow stem cells, intensified by inflammation around channels performed by laser.

Aim: To assess the effect of a combined treatment consisting of transmyocardial laser revascularisation (TLMR) and intramyocardial injection of bone-marrow derived stem cells (bone marrow laser revascularisation, BMLR) in patients with refractory angina one year after the procedure. Read More

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October 2013