Skip to main content
Journal cover image

Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers.

Publication ,  Journal Article
Hughes, GC; Kypson, AP; Annex, BH; Yin, B; St Louis, JD; Biswas, SS; Coleman, RE; DeGrado, TR; Donovan, CL; Landolfo, KP; Lowe, JE
Published in: Ann Thorac Surg
August 2000

BACKGROUND: Transmyocardial laser revascularization (TMR) is an emerging treatment for end-stage coronary artery disease. A variety of lasers are currently available to perform the procedure, although their relative efficacy is unknown. The purpose of this study was to compare changes in myocardial blood flow and function 6 months after TMR with holmium:yttrium-aluminum-garnet (holmium:YAG), carbon dioxide (CO2), and xenon chloride excimer lasers in a model of chronic ischemia. METHODS: Miniswine underwent subtotal (90%) left circumflex coronary stenosis. Baseline positron emission tomography and dobutamine stress echocardiography were performed to document hibernating myocardium in the left circumflex coronary artery distribution. Animals were then randomized to sham redo-thoracotomy (n = 5) or TMR using a holmium:YAG (n = 5), CO2 (n = 5) or excimer (n = 5) laser. Six months postoperatively, the positron emission tomography and dobutamine stress echocardiography studies were repeated and the animals sacrificed. RESULTS: In animals undergoing TMR with holmium: YAG and CO2 lasers, a significant improvement in myocardial blood flow to the lased left circumflex regions was seen. No significant change in myocardial blood flow was seen in sham- or excimer-lased animals. There was a significant improvement in regional stress function of the lased segments 6 months postoperatively in animals undergoing holmium:YAG and CO2 laser TMR that was consistent with a reduction in ischemia. There was no change in wall motion in sham- or excimer-lased animals. Significantly greater neovascularization was observed in the holmium:YAG and CO2 lased regions than with either the sham procedure or excimer TMR. CONCLUSIONS: Transmyocardial laser revascularization with either holmium:YAG or CO2 laser improves myocardial blood flow and contractile reserve in lased regions 6 months postoperatively. These changes were not seen following excimer TMR or sham thoracotomy, suggesting that differences in laser energy or wavelength or both may be important in the induction of angiogenesis.

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

August 2000

Volume

70

Issue

2

Start / End Page

504 / 509

Location

Netherlands

Related Subject Headings

  • Yttrium
  • Tomography, Emission-Computed
  • Swine
  • Respiratory System
  • Neovascularization, Physiologic
  • Myocardial Stunning
  • Myocardial Revascularization
  • Male
  • Lasers
  • Laser Therapy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hughes, G. C., Kypson, A. P., Annex, B. H., Yin, B., St Louis, J. D., Biswas, S. S., … Lowe, J. E. (2000). Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers. Ann Thorac Surg, 70(2), 504–509. https://doi.org/10.1016/s0003-4975(00)01569-1
Hughes, G. C., A. P. Kypson, B. H. Annex, B. Yin, J. D. St Louis, S. S. Biswas, R. E. Coleman, et al. “Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers.Ann Thorac Surg 70, no. 2 (August 2000): 504–9. https://doi.org/10.1016/s0003-4975(00)01569-1.
Hughes GC, Kypson AP, Annex BH, Yin B, St Louis JD, Biswas SS, et al. Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers. Ann Thorac Surg. 2000 Aug;70(2):504–9.
Hughes, G. C., et al. “Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers.Ann Thorac Surg, vol. 70, no. 2, Aug. 2000, pp. 504–09. Pubmed, doi:10.1016/s0003-4975(00)01569-1.
Hughes GC, Kypson AP, Annex BH, Yin B, St Louis JD, Biswas SS, Coleman RE, DeGrado TR, Donovan CL, Landolfo KP, Lowe JE. Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers. Ann Thorac Surg. 2000 Aug;70(2):504–509.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

August 2000

Volume

70

Issue

2

Start / End Page

504 / 509

Location

Netherlands

Related Subject Headings

  • Yttrium
  • Tomography, Emission-Computed
  • Swine
  • Respiratory System
  • Neovascularization, Physiologic
  • Myocardial Stunning
  • Myocardial Revascularization
  • Male
  • Lasers
  • Laser Therapy