Symptomatic improvement after transmyocardial laser revascularization: how long does it last?

Milano, Aldo Domenico; Pratali, Stefano; Levantino, Maurizio; Mariotti, Rita; Bortolotti, Uberto

doi:10.1016/s0003-4975(00)01657-x

Cited by 22 publications

(7 citation statements)

References 7 publications

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“…Previous clinical trials have repeatedly shown improved angina and have also shown improved exercise tolerance in patients treated with surgical transmyocardial laser revascularization (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). A catheter-based laser revascularization approach was developed to provide equal clinical efficacy without the need for a thoracotomy or general anesthesia, thereby reducing procedural complications and perhaps costs.…”

mentioning

confidence: 99%

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

Leon

Kornowski

Downey

et al. 2005

Journal of the American College of Cardiology

177

121

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mentioning

confidence: 99%

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

Leon

Kornowski

Downey

et al. 2005

Journal of the American College of Cardiology

177

121

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“…As noted, after Ho:YAG TMR, significant short-term angina relief was demonstrated at 1 year, as the average angina class fell from 3.5 ± 0.5 at baseline to 1.8 ± 0.8 at 1 year (p < 0.01). However, the average angina class 3 years after Ho:YAG TMR has been reported to significantly increase to 2.2 ± 0.7 (p = 0.003 vs. at 1 year) [20, 21]. Additionally, at 3 years, only 30% of the patients had a two-class improvement in angina compared to baseline and 70% had a one-class improvement (fig.…”

Section: Resultsmentioning

confidence: 99%

Mechanisms and Results of Transmyocardial Laser Revascularization

Horvath

2004

Cardiology

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Transmyocardial laser revascularization (TMR) is a technique that has been performed on over 10,000 patients around the world. Most of the patients were not suffering from heart failure. TMR is principally used for the treatment of angina, but in patients with significant reversible ischemia that is not amenable to conventional therapy, TMR may also improve myocardial function. The results of using TMR as a treatment for angina show a dramatic improvement in symptoms and quality of life. This paper reviews the current status of TMR techniques, mechanisms and results.

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“…Recently, 3-year results after TMR with an Ho:YAG laser were reported. 9 Patients in the Ho:YAG study met the same inclusion criteria and had the same baseline demographics as those in our study. Significant short-term angina relief at 1 year was also documented with the Ho:YAG device.…”

Section: Discussionmentioning

confidence: 99%

Sustained Angina Relief 5 Years After Transmyocardial Laser Revascularization With a CO₂Laser

Horvath

Aranki²,

Cohn³

et al. 2001

Circulation

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Background-Although transmyocardial laser revascularization (TMR) has provided symptomatic relief of angina over the short term, the long-term efficacy of the procedure is unknown. Angina symptoms as assessed independently by angina class and the Seattle Angina Questionnaire (SAQ) were prospectively collected up to 7 years after TMR. Methods-Seventy-eight patients with severe angina not amenable to conventional revascularization were treated with a CO 2 laser. Their mean age was 61Ϯ10 years at the time of treatment. Preoperatively, 66% had unstable angina, 73% had had Ն1 myocardial infarction, 93% had undergone Ն1 CABG, 42% had Ն1 PTCA, 76% were in angina class IV, and 24% were in angina class III. Their average pre-TMR angina class was 3.7Ϯ0.4. Results-After an average of 5 years (and up to 7 years) of follow-up, the average angina class was significantly improved to 1.6Ϯ1 (Pϭ0.0001). This was unchanged from the 1.5Ϯ1 average angina class at 1 year postoperatively (PϭNS).There was a marked redistribution according to angina class, with 81% of the patients in class II or better, and 17% of the patients had no angina 5 years after TMR. A decrease of Ն2 angina classes was considered significant, and by this criterion, 68% of the patients had successful long-term angina relief. The angina class results were further confirmed with the SAQ; 5-year SAQ scores revealed an average improvement of 170% over the baseline results. Conclusions-The long-term efficacy of TMR persists for Ն5 years. TMR with CO 2 laser as sole therapy for severe disabling angina provides significant long-term angina relief.

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Symptomatic improvement after transmyocardial laser revascularization: how long does it last?

Cited by 22 publications

References 7 publications

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

Mechanisms and Results of Transmyocardial Laser Revascularization

Sustained Angina Relief 5 Years After Transmyocardial Laser Revascularization With a CO₂Laser

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Symptomatic improvement after transmyocardial laser revascularization: how long does it last?

Cited by 22 publications

References 7 publications

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

A Blinded, Randomized, Placebo-Controlled Trial of Percutaneous Laser Myocardial Revascularization to Improve Angina Symptoms in Patients With Severe Coronary Disease

Mechanisms and Results of Transmyocardial Laser Revascularization

Sustained Angina Relief 5 Years After Transmyocardial Laser Revascularization With a CO2Laser

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Sustained Angina Relief 5 Years After Transmyocardial Laser Revascularization With a CO₂Laser