Abstract
Direct myocardial revascularization (DMR), either surgical or catheter-based, uses lasers to create channels between ischemic myocardium and the left ventricular cavity to improve perfusion and decrease angina. This technique can also be used to deliver drugs to the damaged tissue. Candidates include patients with chronic, severe, refractory angina and those unable to undergo conventional surgical revascularization or angioplasty because remaining conduits or acceptable target vessels are lacking. Although the mechanism of action of DMR is still not known, several theories have been proposed, including stimulated angiogenesis. Late sequelae also remain to be determined. Channel characteristics differ depending on whether they were created by carbon dioxide or holmium/yttrium-aluminum-garnet (Ho: YAG) lasers. Catheter-based DMR obviates thoracotomy and anesthesia and, in systems that can create electromechanical maps, fluoroscopy. Phase I clinical trials are now under way to evaluate catheter-based DMR, with endpoints that include improvement in symptoms of angina, exercise capacity, and radionuclide myocardial perfusion.
References
Apr 1, 1988·The Annals of Thoracic Surgery·M MirhoseiniM M Cayton
Dec 1, 1968·The Annals of Thoracic Surgery·M White, J E Hershey
Jan 1, 1995·Journal of the American College of Cardiology·K A HorvathL H Cohn
Mar 1, 1993·Circulation Research·R von HarsdorfB Nadal-Ginard
Jan 21, 1997·Circulation·N GasslerU Helmchen
Mar 18, 1997·Circulation·P Whittaker, R A Kloner
Mar 18, 1997·Circulation·L GepsteinS A Ben-Haim
Sep 1, 1997·Journal of the American College of Cardiology·C L DonovanT Ryan
Nov 1, 1935·Annals of Surgery·C S Beck
Citations
Apr 17, 2001·Clinical Cardiology·N HayatN Khan
Nov 30, 2006·Pain Practice : the Official Journal of World Institute of Pain·O A Latif, P P Raj
Sep 1, 2005·Future Cardiology·Ran KornowskiNili Zafrir
Nov 24, 2004·Journal of Atherosclerosis and Thrombosis·Hiroshi TakaishiMitsuhiro Yokoyama
Sep 15, 2000·Cardiology Clinics·M CourtoisS J Kovács
May 12, 2004·Chest·Gil BolotinGideon Uretzky
Jul 13, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R KornowskiM B Leon
Nov 15, 2002·International Journal of Cardiovascular Interventions·Uri OronShlomo Ben-Haim
Nov 24, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R Kornowski, M B Leon
Sep 7, 2000·Circulation·R KornowskiM B Leon
Apr 9, 2010·Coronary Artery Disease·Yun LuanGuo-Wei He
Dec 20, 2008·Journal of General Internal Medicine·Milda R Saunders, G Caleb Alexander
Nov 17, 1998·Herz·U QuastM Bambynek
Oct 1, 2004·Lab Animal·Roberto Refinetti
Mar 10, 2010·Journal of General Internal Medicine·Emily A WangDavid A Fiellin
Sep 10, 2011·Current HIV/AIDS Reports·Josiah D RichUNKNOWN Centers for AIDS Research—Collaboration on HIV in Corrections (CFAR-CHIC) Working Group
Jan 16, 2015·Applied Clinical Informatics·R LuceroV Tiase
Jun 2, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R J Laham, D S Baim
May 18, 2000·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·J LessickS A Ben-Haim
Mar 14, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·J LessickS A Ben-Haim
Jun 8, 2000·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R Kornowski, A J Lansky
Jul 23, 2002·Journal of Applied Physiology·Jonathan LessickShlomo A Ben-Haim
Feb 21, 2021·Medical Engineering & Physics·Awaz AliPaul Breedveld
Jun 23, 1999·Mayo Clinic Proceedings·B KantorR S Schwartz