Evidence of vascular growth associated with laser treatment of normal canine myocardium.
BACKGROUND
Transmyocardial laser revascularization is a new therapy for patients with refractory angina. Although clinical studies suggest that transmyocardial laser revascularization decreases angina and may improve regional blood flow, the underlying mechanisms are not elucidated. We hypothesized that one mechanism may relate to stimulation of vascular growth in laser-treated regions.


METHODS
Transmyocardial laser revascularization channels were made with holmium:yttrium-aluminum garnet or carbon dioxide lasers in eight normal canine hearts; animals were sacrificed 2 to 3 weeks later and examined for vascular density and for evidence of smooth muscle proliferation.


RESULTS
The original channels were infiltrated by granulation tissue with associated vascularity. Vascular growth was stimulated immediately surrounding the channel remnant as evidenced by an increase in the number of vessels (approximately twice that of the control region) and an increase in the number of vascular cells staining positive for markers of cellular proliferation.


CONCLUSIONS
Transmyocardial laser revascularization leads to local vascular growth as early as 2 weeks after treatment. It remains to be determined whether this mechanism contributes to increased regional blood flow or to clinical benefits associated with this novel form of therapy.
Kohmoto
T
T
Department of Surgery, Columbia Presbyterian Medical Center, New York, New York, USA.
DeRosa
C M
CM
Yamamoto
N
N
Fisher
P E
PE
Failey
P
P
Smith
C R
CR
Burkhoff
D
D
D000538:Aluminum Silicates; D000818:Animals; D001160:Arterioles / Q000473:pathology; D002196:Capillaries / Q000473:pathology; D002245:Carbon Dioxide; D002455:Cell Division; D002467:Cell Nucleus / Q000648:ultrastructure; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology; D004285:Dogs; D005167:Factor VII / Q000032:analysis; D006097:Granulation Tissue / Q000473:pathology; D006695:Holmium; D053685:Laser Therapy / Q000379:methods*; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D009204:Myocardial Revascularization / Q000379:methods*; D009206:Myocardium / Q000473:pathology; D018919:Neovascularization, Physiologic; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D015019:Yttrium
D000538:Aluminum Silicates; D018809:Proliferating Cell Nuclear Antigen; D002245:Carbon Dioxide; D015019:Yttrium; D005167:Factor VII; D006695:Holmium