PMID: 9434682Jan 22, 1998Paper

Transmyocardial laser treatment denervates canine myocardium

The Journal of Thoracic and Cardiovascular Surgery
K F KwongT M Sundt

Abstract

In patients with refractory angina who are not candidates for conventional revascularization, transmyocardial laser treatment reduces angina significantly in the early postoperative period. We hypothesized that transmyocardial laser treatment damages cardiac nerve fibers that convey the pain of angina pectoris. Left thoracotomy was performed in sixteen adult mongrel dogs. Treatment groups included animals in which a portion of the left ventricle underwent creation of transmyocardial channels with a holmium:yttrium-aluminum-garnet laser (n = 5) or chemical destruction of cardiac nerves by application of phenol to the epicardium (n = 5). Sham-operated negative control animals underwent thoracotomy and pericardiotomy alone (n = 6). Cardiac afferent nerve function was assessed by epicardial application of bradykinin, a potent algesic, before treatment and 2 weeks after the operation. The resulting central nervous system-mediated decrease in systemic mean arterial pressure was measured. Cardiac innervation of treated and untreated left ventricular myocardium was further assessed by immunoblot analysis performed with an antibody against tyrosine hydroxylase, a sympathetic nerve-specific enzyme. Before treatment, changes in systemic a...Continue Reading

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