Transmyocardial Laser Revascularization: A Meta-Analysis and Systematic Review of Controlled Trials

Abstract

were defined as improvement in NYHA or CCS class by at least 2 classes, perioperative pain, patient satisfaction or preference, and quality of life (QOL). B. Perioperative and Long-term Complications Myocardial infarction (as defined by the study authors), stroke or neurologic event, need for repeat intervention (CABG or PCI), surgical reexploration, transfusions, renal failure, or a composite of all perioperative complications. Changes in results of imaging studies such as perfusion imaging wall motion studies, ejection fraction, exercise treadmill stress testing (ETT), and hemodynamic assessment will also be considered. C. Resource Utilization Duration of procedure, ICU length of stay, total hospital length of stay, emergency department visits, doctor visits, rehospitalizations, and costs. METHODS This meta-analysis of randomized trials was performed in accordance with state of the art methodologic recommendations 6,7 and according to a protocol that prespecified outcomes, search strategies, inclusion criteria, and statistical analyses.

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

“…In a meta-analysis of patients with CAD who underwent TMR while receiving optimal medical management, Cheng et al 11 discovered a statistically significant improvement in the number of patients experiencing severe angina, readmission rates after 1 year and the need for reintervention secondary to coronary ischemia. Despite significant symptomatic improvement, the authors did not find a difference in mortality rates, MI or stroke between the two groups.…”

Transmyocardial revascularization devices: technology update

“…A meta-analysis looking at 1-year survival in randomized patients showed similar survival between patients treated with laser and those managed with medical therapy alone. 32 Functional analysis looking at myocardial perfusion showed some evidence of improvement in reversible ischemic defects and perfusion of ischemic territories with the CO 2 laser. 24 , 26 …”