The vascular response induced by transmyocardial laser revascularization is determined by the size of the channel scar: Results of CO<sub>2</sub>, holmium and excimer lasers

Huikeshoven, Menno; Beliën, Jeroen A.M.; Tukkie, Raymond; Beek, Hans van

doi:10.1002/lsm.20070

Cited by 7 publications

(2 citation statements)

References 21 publications

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“…Some studies have investigated endothelium‐lined patent channels 13–15. However, more experiments have shown that many laser channels are occluded by fibrous scar tissue after TMLR 16–18. Similarly, channels made by mechanical puncture can also become occluded 19…”

Section: Discussionmentioning

confidence: 99%

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

Zhou

et al. 2012

J Biomedical Materials Res

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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. After 6 weeks, the patency of the channels and angiogenesis around the channels were assessed by hematoxylin-eosin staining, immunohistochemistry, and Masson's trichrome staining. Results suggest that the channels in the CH and CH + GF groups may retain patency with luminal endothelization. Moreover, the vessel densities of the NS, CH, and CH + GF groups were significantly higher than that of the MI group, and that of the CH + GF group was the highest (p < 0.05). This study suggests that TMJR with chitosan scaffolds may help retain transmyocardial channel patency and enhance angiogenesis after AMI in canines.

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Section: Discussionmentioning

confidence: 99%

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

Zhou

et al. 2012

J Biomedical Materials Res

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“…With a smaller scar channel (CO 2 laser) there is greater angiogenesis in the scar. Additional experiments of histologically tracking laser tissue interactions over time revealed that the acute thermal injury and initial scarring at 2–3 weeks was greater with a Ho:YAG laser than with a CO 2 laser [13]. There was scar contracture over time and at 6 weeks there was little difference between the groups.…”

Section: Discussionmentioning

confidence: 99%

Does laser type impact myocardial function following transmyocardial laser revascularization?

et al. 2010

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Background Transmyocardial laser revascularization (TMR) is currently clinically performed with either a CO2 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. After collecting baseline functional data with cine magnetic resonance imaging (MRI) and dobutamine stress echo (DSE), 14 animals underwent TMR with either a CO2 or Ho:YAG laser. Transmural channels were created with each laser in a distribution of 1/cm2 in the ischemic zone. Six weeks post-treatment repeat MRI as well as DSE were obtained after which the animals were sacrificed. Histology was preformed to characterize the laser–tissue interaction. Results CO2 TMR led to improvement in wall thickening in the ischemic area as seen with cine MRI (40.3% vs. baseline, P < 0.05) and DSE (20.2% increase vs. baseline, P < 0.05). Ho:YAG treated animals had no improvement in wall thickening by MRI (−11.6% vs. baseline, P = .67) and DSE (−16.7% vs. baseline, P = 0.08). Correlative semi-quantitative histology revealed a significantly higher fibrosis index in Ho:YAG treated myocardium versus CO2 (1.81 vs. 0.083, P < 0.05). Conclusions In a side-by-side comparison CO2 TMR resulted in improved function of ischemic myocardium as assessed by MRI and echocardiography. Ho:YAG TMR led to no improvement in regional function likely due to concomitant increase in fibrosis in the lasered area.

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Transmyocardial revascularization (TMR): current status and future directions

Allen

Mahoney

Aggarwal

et al. 2018

Indian J Thorac Cardiovasc Surg

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The vascular response induced by transmyocardial laser revascularization is determined by the size of the channel scar: Results of CO₂, holmium and excimer lasers

Abstract: These results indicate that the angiogenic response following TMLR is limited to the channel scar and related to the scar size rather than the specific laser type.

Cited by 7 publications

References 21 publications

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

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

Does laser type impact myocardial function following transmyocardial laser revascularization?

Transmyocardial revascularization (TMR): current status and future directions

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The vascular response induced by transmyocardial laser revascularization is determined by the size of the channel scar: Results of CO2, holmium and excimer lasers

Abstract: These results indicate that the angiogenic response following TMLR is limited to the channel scar and related to the scar size rather than the specific laser type.

Cited by 7 publications

References 21 publications

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

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

Does laser type impact myocardial function following transmyocardial laser revascularization?

Transmyocardial revascularization (TMR): current status and future directions

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Product

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The vascular response induced by transmyocardial laser revascularization is determined by the size of the channel scar: Results of CO₂, holmium and excimer lasers