Transmyocardial laser revascularization in allograft coronary artery disease.
We used transmyocardial laser revascularization to treat accelerated cardiac allograft atherosclerosis in 2 patients. One patient received transmyocardial laser revascularization as sole therapy, the other as an adjunct to coronary artery bypass grafting. The systolic function improved in both patients, although the patient who had adjunctive transmyocardial laser revascularization died of systemic infection and renal failure on postoperative day 55. The second patient is alive and well 1 1/2 years after the laser procedure. We discuss 4 other patients who received transmyocardial laser revascularization treatment elsewhere in the United States. Transmyocardial laser revascularization has the potential to become important in the treatment of transplant atherosclerosis. Randomized clinical trials are warranted to assess the efficacy of transmyocardial laser revascularization in this setting.
Frazier
O H
OH
Division of Cardiopulmonary Transplantation, Cullen Cardiovascular Research Laboratories, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston 77225-0345, USA.
Kadipasaoglu
K A
KA
Radovancevic
B
B
Cihan
H B
HB
March
R J
RJ
Mirhoseini
M
M
Cooley
D A
DA
D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007430:Intraoperative Care; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000209:etiology; D012501:Saphenous Vein / Q000637:transplantation; D018805:Sepsis / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D013599:Systole; D014184:Transplantation, Homologous; D018084:Ultrasonography, Interventional