583 results match your criteria Transmyocardial Laser Revascularization


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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http://dx.doi.org/10.5114/aic.2018.76409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041827PMC
June 2018
5 Reads

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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http://link.springer.com/10.1007/s10103-018-2514-9
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http://dx.doi.org/10.1007/s10103-018-2514-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133034PMC
September 2018
11 Reads

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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http://dx.doi.org/10.1097/MJT.0000000000000653DOI Listing
September 2018
6 Reads
1.130 Impact Factor

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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http://academic.oup.com/icvts/article/25/5/848/3855104
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http://dx.doi.org/10.1093/icvts/ivx146DOI Listing
November 2017
16 Reads

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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http://dx.doi.org/10.1186/s13019-017-0602-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438520PMC
May 2017
18 Reads

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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May 2018
3 Reads

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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http://dx.doi.org/10.1186/s40064-016-2355-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909685PMC
July 2016
15 Reads

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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http://dx.doi.org/10.1093/icvts/ivv386DOI Listing
April 2016
4 Reads

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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May 2018
5 Reads

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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http://dx.doi.org/10.1016/j.hfc.2015.08.009DOI Listing
January 2016
4 Reads

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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http://www.atcs.jp/pdf/2003_9_6/378.pdf
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March 2015
51 Reads

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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https://www.uthsc.edu/cardiology/articles/TMR.pdf
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http://www.sts.org/sites/default/files/documents/pdf/guideli
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http://link.springer.com/content/pdf/10.1007%2F978-1-59259-9
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http://doi.wiley.com/10.1002/14651858.CD003712.pub3
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http://dx.doi.org/10.1002/14651858.CD003712.pub3DOI Listing
February 2015
4 Reads

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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http://dx.doi.org/10.2147/MDER.S51591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274152PMC
January 2015
6 Reads

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

Stem Cell Rev 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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http://dx.doi.org/10.1007/s12015-014-9571-7DOI Listing
April 2015
10 Reads

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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http://dx.doi.org/10.1097/IMI.0000000000000094DOI Listing
June 2015
4 Reads

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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https://linkinghub.elsevier.com/retrieve/pii/S07338651140003
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http://dx.doi.org/10.1016/j.ccl.2014.04.009DOI Listing
August 2014
14 Reads

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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http://dx.doi.org/10.1007/s11596-014-1262-8DOI Listing
April 2014
7 Reads

[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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March 2013
3 Reads

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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http://dx.doi.org/10.1213/ANE.0000000000000098DOI Listing
March 2014
5 Reads

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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http://dx.doi.org/10.1177/2050313X14526873DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857340PMC
August 2016
7 Reads

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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http://dx.doi.org/10.5603/KP.2013.0095DOI Listing
October 2013
5 Reads

The effectiveness of enhanced external counterpulsation (EECP) in patients suffering from chronic refractory angina previously treated with transmyocardial laser revascularisation.

Int J Cardiol 2013 Oct 25;168(4):4383-5. Epub 2013 May 25.

Academic Cardiology Department, University of Hull, Castle Hill Hospital, Hull, UK; Cardiology Department, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK. Electronic address:

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http://dx.doi.org/10.1016/j.ijcard.2013.05.050DOI Listing
October 2013
10 Reads

Effects of transmyocardial jet revascularization with chitosan hydrogel on channel patency and angiogenesis in canine infarcted hearts.

J Biomed Mater Res A 2013 Feb 4;101(2):567-74. Epub 2012 Sep 4.

Department of Cardiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China.

The purpose of this study was to investigate whether transmyocardial jet revascularization (TMJR) with chitosan scaffolds retains channel patency and enhances angiogenesis after acute myocardial infarction (AMI) in a canine model. A total of 32 canines were randomly divided into four groups: myocardial infarction (MI), normal saline (NS), chitosan hydrogel (CH), and chitosan plus growth factor (CH + GF) groups. TMJR was performed surgically using a needle-free injector from the epicardium of canines in the NS, CH, and CH + GF groups; channels were filled with NS, CH, and CH + GF, respectively. Read More

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http://dx.doi.org/10.1002/jbm.a.34346DOI Listing
February 2013
4 Reads

[Remote results of open interventions in treatment of abdominal aortic aneurysms].

Angiol Sosud Khir 2012 ;18(2):107-15

Analysed herein are the results of treating a total of 471 patients operated on at the Department of Surgical Treatment for Arterial Pathology of the Research Centre of Cardiovascular Surgery named after A. N. Bakulev under the Russian Academy of Medical Sciences for an aneurysm of the infrarenal portion of the abdominal aorta. Read More

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October 2012
3 Reads

Long-term outcomes after transmyocardial revascularization.

Ann Thorac Surg 2012 Nov 25;94(5):1500-8. Epub 2012 Jul 25.

US Food and Drug Administration, Center for Devices and Radiological Health, Division of Epidemiology, Silver Spring, MD 20993, USA.

Background: Two independent reports documented substantially higher operative mortality associated with transmyocardial revascularization (TMR) when used in isolation than that reported in the premarket clinical trials. To clarify the state of the art, this article assesses temporal trends in the use of TMR, short-term and long-term outcomes, and outcomes stratified by procedure type (TMR only and TMR + coronary artery bypass graft [CABG]) and by the 2 specific TMR devices.

Methods: The study population included all patients undergoing TMR in isolation or in combination with CABG at 435 cardiothoracic hospitals in the United States participating in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) from January 2000 through November 2006 (n = 15,386). Read More

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http://dx.doi.org/10.1016/j.athoracsur.2012.05.068DOI Listing
November 2012
23 Reads

Coronary computed tomographic angiography for prediction of procedural and intermediate outcome of bypass grafting to left anterior descending artery occlusion with failed visualization on conventional angiography.

Am J Cardiol 2012 Jun 3;109(12):1722-8. Epub 2012 Apr 3.

Institute of Cardiology, Warsaw, Poland.

Conventional coronary angiography (CCA) has considerable limitations regarding visualization of distal vessel segments in chronic total occlusion. We assessed the ability of coronary computed tomographic angiography (CCTA) to predict the success of coronary artery bypass grafting (CABG) to the chronically occluded left anterior descending coronary artery (LAD) incompletely visualized on CCA. Thirty symptomatic patients rejected for CABG on the basis of the CCA findings underwent preoperative CCTA before intended transmyocardial laser revascularization. Read More

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http://dx.doi.org/10.1016/j.amjcard.2012.02.015DOI Listing
June 2012
10 Reads

Thoracic compartment syndrome: a case report.

Heart Surg Forum 2012 Feb;15(1):E46-8

Department of Cardiopulmonary Transplantation and the Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA.

Thoracic compartment syndrome has been observed after trauma and after mediastinal and cardiac procedures; however, an adult respiratory distress syndrome (ARDS)-like presentation has not been described as a part of thoracic compartment syndrome. We describe the case of an obese patient who underwent coronary artery bypass (his third such procedure) and hiatal hernia reduction during the same operation, followed by transmyocardial laser revascularization and full chest closure the next day. The patient was hypoxic after chest closure. Read More

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http://journal.hsforum.com/index.php/HSF/article/view/185
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http://dx.doi.org/10.1532/HSF98.20111071DOI Listing
February 2012
4 Reads

Transmyocardial laser revascularization. Personal experience.

G Chir 2011 Nov-Dec;32(11-12):464-6

Mauriziano Umberto I"Hospital, Turin, Italy.

Background: Indirect revascularization is a therapeutic approach in case of severe angina not suitable for percutaneous or surgical revascularization. Transmyocardial revascularization (TMR) is one of the techniques used for indirect revascularization and it allows to create transmyocardial channels by a laser energy bundle delivered on left ventricular epicardial surface. Benefits of the procedure are related mainly to the angiogenesis caused by inflammation and secondly to the destruction of the nervous fibers of the heart. Read More

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March 2012
9 Reads

Transmyocardial drilling revascularization combined with heparinized bFGF-incorporating stent activates resident cardiac stem cells via SDF-1/CXCR4 axis.

Exp Cell Res 2012 Feb 28;318(4):391-9. Epub 2011 Nov 28.

Department of Cardiac Surgery and Neurology, The First Hospital of China Medical University, Shenyang 110001, China.

Objective: To investigate whether transmyocardial drilling revascularization combined with heparinized basic fibroblast growth factor (bFGF)-incorporating degradable stent implantation (TMDRSI) can promote myocardial regeneration after acute myocardial infarction (AMI).

Methods: A model of AMI was generated by ligating the mid-third of left anterior descending artery (LAD) of miniswine. After 6 h, the animals were divided into none-treatment (control) group (n=6) and TMDRSI group (n=6). Read More

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http://dx.doi.org/10.1016/j.yexcr.2011.11.009DOI Listing
February 2012
5 Reads

Late angiograms ten years after transmyocardial laser revascularization.

Coron Artery Dis 2011 Dec;22(8):583-4

Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy.

We present the angiograms of a patient after transmyocardial laser revascularization (TMR), which were performed 10 years before by the application of holmium laser pulses. Thirteen years before the TMR procedure, the patient underwent coronary artery bypass graftings complicated by graft occlusion with no longer possibility of direct revascularization. Then, refractive angina required an alternative approach for symptom relief as the indirect revascularization by the application of the holmium laser pulses. Read More

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http://dx.doi.org/10.1097/MCA.0b013e32834c7534DOI Listing
December 2011
4 Reads

Computed tomography to predict surgical revascularization of a left anterior descending artery occlusion incompletely visualized by conventional angiography.

J Thorac Imaging 2012 May;27(3):184-93

Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.

Purpose: Previous studies demonstrated that failure to visualize distal chronic total occlusion in conventional coronary angiography (CCA) does not preclude procedural success of coronary artery bypass grafting (CABG). We assessed the utility of computed tomography angiography (CTA) in guiding CABG to the occluded left anterior descending artery (LAD) incompletely visualized by CCA.

Materials And Methods: Twenty-four symptomatic patients rejected for revascularization of an occluded LAD on the basis of CCA underwent a preoperative CTA before intended transmyocardial laser revascularization. Read More

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http://dx.doi.org/10.1097/RTI.0b013e31821ccf46DOI Listing
May 2012
6 Reads

Management of refractory angina pectoris.

Cardiol J 2011 ;18(4):343-51

Intermountain Valley View Heart Clinic, Cedar City, UT, USA.

Despite significant advances in revascularization techniques and medical therapy, there remains a significant population of patients who continue to have intractable angina symptoms. This review aims to define the patients with refractory angina pectoris (RAP) and to present the therapeutic options currently available for this condition. RAP itself is defined and the pharmacological treatment options other than traditional medical therapies are discussed. Read More

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November 2011
14 Reads

Does laser type impact myocardial function following transmyocardial laser revascularization?

Lasers Surg Med 2010 Dec;42(10):746-51

National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.

Background: Transmyocardial laser revascularization (TMR) is currently clinically performed with either a CO(2) or Ho:YAG laser for the treatment of severe angina. While both lasers provide symptomatic relief, there are significant differences in the laser-tissue interactions specific to each device that may impact their ability to enhance the perfusion of myocardium and thereby improve contractile function of the ischemic heart.

Methods: A porcine model of chronic myocardial ischemia was employed. Read More

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http://dx.doi.org/10.1002/lsm.21012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411323PMC
December 2010
4 Reads

Morphological and molecular analysis of angiogenesis after intramyocardial transplantation of autologous bone marrow mononuclear cells.

Bull Exp Biol Med 2010 Oct;149(4):515-20

E N Meshalkin Research Institute of Circulatory Pathology, Federal Agency for HighTechnological Medical Care, Novosibirsk, Russia.

We studied the peculiarities of angiogenesis in the postinfarction period after transmyocardial laser revascularization and intramyocardial implantation of mononuclear bone marrow cells into the pericicatrical zone of the left ventricular myocardium in dogs. Morphological manifestation of angiogenesis in the myocardium after application of laser and cell technologies are angiomatosis, formation of large thin-wall vessels and sinusoids. The angiogenic effect of implanted mononuclear bone marrow cells is determined by high content (43-47%) of CD31+ cells in both adherent and nonadherent fractions. Read More

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October 2010
4 Reads

Clinical application of laser treatment for cardiovascular surgery.

Laser Ther 2011 ;20(3):217-32

International Institute for Advanced General Medicine.

Background: Recently, several kinds of lasers have been widely employed in the field of medicine and surgery. However, laser applications are very rare in the field of cardiovascular surgery throughout the world. So, we have experimentally tried to use lasers in the field of cardiovascular surgery. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799031PMC
June 2014
5 Reads

Treatment of stable angina pectoris.

Am J Ther 2011 Sep;18(5):e138-52

Division of Cardiology, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY 10595, USA.

Management of stable angina pectoris includes antianginal medications, medications to prevent progression of atherosclerosis, and aggressive treatment of causative risk factors. Antianginal medications commonly used include nitrates, beta-blockers, calcium channel blockers, and ranolazine. Antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors are used in patients with these problems to prevent progression of atherosclerosis and/or premature cardiovascular death. Read More

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http://dx.doi.org/10.1097/MJT.0b013e3181f2ab9dDOI Listing
September 2011
2 Reads

Effectiveness of percutaneous laser revascularization therapy for refractory angina.

Vasc Health Risk Manag 2010 Sep 7;6:735-47. Epub 2010 Sep 7.

University of Toronto, Toronto, ON, Canada.

Refractory angina is a debilitating disease characterized by persistent cardiac pain resistant to all conventional treatments for coronary artery disease. Percutaneous myocardial laser revascularization (PMLR) has been proposed to improve symptoms in these patients. We used meta-analysis to assess the effectiveness of PMLR versus optimal medical therapy for improving angina symptoms, health-related quality of life (HRQL), and exercise performance; the impact on all-cause mortality was also examined. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941786PMC
September 2010
3 Reads

Mid term results after bone marrow laser revascularization for treating refractory angina.

BMC Cardiovasc Disord 2010 Sep 17;10:42. Epub 2010 Sep 17.

Department of Cardiovascular Surgery, Hospital Universitario La Princesa, Madrid 28006, Spain.

Background: To evaluate the midterm results of patients with angina and diffuse coronary artery disease treated with transmyocardial revascularization in combination with autologous stem cell therapy.

Methods: Nineteen patients with diffuse coronary artery disease and medically refractory class III/IV angina were evaluated between June 2007 and December 2009 for sole therapy TMR combined with intramyocardial injection of concentrated stem cells. At the time of surgery, autologous bone marrow (120cc) was aspirated from the iliac crest. Read More

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http://bmccardiovascdisord.biomedcentral.com/articles/10.118
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http://dx.doi.org/10.1186/1471-2261-10-42DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949625PMC
September 2010
5 Reads

Transmyocardial laser revascularization 12 years later.

Interact Cardiovasc Thorac Surg 2010 Oct 15;11(4):480-1. Epub 2010 Jul 15.

Section of Cardiac Surgery, Cardiac Thoracic and Vascular Department, University of Pisa Medical School, Pisa, Italy.

We report the long-term follow-up of 34 patients who underwent transmyocardial laser revascularization (TMLR) from 1995 to 1999. At 12 years the actuarial survival is 24%±8%, actuarial freedom from cardiac deaths is 36%±10% and actuarial freedom from major adverse cardiac events 13%±8%. Mean angina class of nine current survivors is 2. Read More

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http://dx.doi.org/10.1510/icvts.2010.243618DOI Listing
October 2010
2 Reads

NICE evaluation of transmyocardial laser revascularisation and percutaneous laser revascularisation for refractory angina.

Heart 2010 Feb;96(4):312-3

Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge CB23 3RE, UK.

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http://heart.bmj.com/cgi/doi/10.1136/hrt.2009.185769
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http://dx.doi.org/10.1136/hrt.2009.185769DOI Listing
February 2010
2 Reads

[Alternative methods of myocardial revascularization].

Vestn Ross Akad Med Nauk 2009 (12):46-51

The study was designed to analyse results of alternative methods of myocardial revascularization in "no-option patients" to whom direct revascularization is not indicated. Over 600 cases were treated with the use of transmyocardial laser revascularization (TMLR), angiogenic factors (VEGF, alpha-ECGF), and cellular therapy. It was shown that TMLR is a safe and efficacious procedure increasing perfusion and normalizing myocardial metabolism. Read More

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March 2010
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Assessment of myocardial perfusion by positron emission tomography in patients with end-stage coronary artery disease treated with percutaneous myocardial revascularization.

Chin Med J (Engl) 2009 Dec;122(23):2807-13

Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstrasse 11, Bad Oeynhausen, Germany.

Background: Reportedly, patients with persistent refractory angina due to end-stage coronary artery disease (CAD) not amenable to traditional revascularization techniques have experienced symptomatic relief following laser revascularization, either surgical transmyocardial revascularization (TMR) or percutaneous myocardial revascularization (PMR). In spite of several hypotheses (i.e. Read More

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December 2009
4 Reads

Transmyocardial laser revascularization combined with intramyocardial endothelial progenitor cell transplantation in patients with intractable ischemic heart disease ineligible for conventional revascularization: preliminary results in a highly selected small patient cohort.

Thorac Cardiovasc Surg 2010 Feb 13;58(1):11-6. Epub 2010 Jan 13.

Cardiac and Thoracic Vascular Surgery Clinic, University of Luebeck, Luebeck, Germany.

Objective: Transmyocardial laser revascularization for angina relief and intramyocardial autologous endothelial progenitor cell injection for neoangiogenesis may offer a new treatment strategy for patients with intractable ischemic heart disease.

Methods: Transmyocardial laser revascularization and intramyocardial injection of bone marrow-derived CD133+ cells was performed in six highly symptomatic patients. Transmyocardial laser channels were created and isolated CD133+ cells were injected intramyocardially. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0029-1186199
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http://dx.doi.org/10.1055/s-0029-1186199DOI Listing
February 2010
4 Reads

[Transmyocardial laser revascularization].

Rozhl Chir 2009 Sep;88(9):489-92

Klinika kardiovaskulární chirurgie IKEM, Praha 4.

Aim Of The Study: The study looked at our results with transmyocardial laser revascularization. We also tried to ascertain the role of TMLR in current cardiothoracic surgical practice.

Methods: Twenty patients underwent TMLR at IKEM Praha in a period from 1999 to 2007. Read More

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September 2009
3 Reads

Intraoperative CD133+ cell transplantation during coronary artery bypass grafting in ischemic cardiomyopathy.

Multimed Man Cardiothorac Surg 2010 Jan;2010(809):mmcts.2009.003947

Clinic for Cardiovascular Surgery, Heinrich-Heine-University Medical School, Moorenstrasse 5, 40225 Duesseldorf, Germany.

If traditional treatment of coronary artery disease has failed, intramyocardial transplantation of CD133+ stem cells with the potential to improve myocardial function is an alternative approach to treating ischemic cardiomyopathy. The INSTEM trial aims at evaluating safety and feasibility of isolation and subsequent intramyocardial transplantation of CD133+ cells in combination with coronary artery bypass grafting (CABG). Patients suffering from severe ischemic cardiomyopathy (ejection fraction ≫15% and ≪35%) are enrolled in this trial. Read More

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http://dx.doi.org/10.1510/mmcts.2009.003947DOI Listing
January 2010
6 Reads

Surgical therapy for complex coronary artery disease.

Semin Thorac Cardiovasc Surg 2009 ;21(3):199-206

Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Recent advances in medical therapy, percutaneous myocardial revascularization, and coronary artery bypass grafting have allowed patients to live longer without eliminating the underlying pathology of coronary artery disease. In this review the authors discuss surgical options, perioperative assessment, procedural details, and outcomes after repeated coronary artery bypass surgery and coronary endarterectomy, in patients with severe coronary artery disease that is not suited for further percutaneous coronary intervention. Furthermore, the authors also discuss the role of transmyocardial revascularization and protein/gene therapy in those extreme situations where complex coronary artery disease is no longer amenable to traditional surgical intervention. Read More

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http://dx.doi.org/10.1053/j.semtcvs.2009.08.006DOI Listing
June 2010
7 Reads

[The effect of transmyocardial laser revascularization on anginal symptoms and clinical results in patients with incomplete surgical revascularization].

Turk Kardiyol Dern Ars 2009 Jun;37(4):246-52

Department of Cardiovascular Surgery, Medicine Faculty of Marmara University, Istanbul, Turkey.

Objectives: We evaluated the effect of transmyocardial laser revascularization (TMR) on anginal symptoms and clinical results in patients in whom coronary artery bypass grafting (CABG) surgery was not sufficient to provide complete revascularization.

Study Design: This retrospective study included 45 patients who underwent CABG surgery with incomplete revascularization between 2003 and 2006. Of these, 35 patients (mean age 61. Read More

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June 2009
7 Reads