title: [Treatment strategies in therapy refractory angina pectoris: transmyocardial laser revascularization].
abstract: BACKGROUND
  Does transmyocardial laser revascularization (TMLR) as a new surgical technique for treating patients with otherwise intractable angina pectoris improve myocardial perfusion or contractility?
  
  
  METHODS
  Sixty-seven patients transferred for TMLR were evaluated by clinical evaluation, treadmill stress testing, echocardiography, ventriculography, and hybrid positron emission tomography preoperatively and in patients treated with TMLR at 6 and 12 month follow up. Hemodynamic assessment and clinical evaluation were performed perioperatively.
  
  
  RESULTS
  In 28/67 cases (42%) CABG, in 9/67 patients (13%) CABG in combination with TMLR (combined group), and in 30/67 patients (45%) only TMLR (sole group) were performed. Perioperative mortality in the sole group was 13%, in the combined group zero, and in the CABG group 11%. In all groups a significantly improved clinical status (p < or = 0.01) 1 week postoperatively and in TMLR groups also at 6 and 12 months was observed. In the TMLR groups treadmill tolerance (p < 0.05) improved, although function, perfusion, and metabolism did not change significantly at the 6 and 12 month follow up.
  
  
  CONCLUSIONS
  TMLR significantly improves clinical status and treadmill stress tolerance, but does not change function, perfusion, and metabolism.
authors.affiliation: Abteilung für Herz- und Gefässchirurgie Albert-Ludwigs-Universität Freiburg.
authors.forename: G
authors.initials: G
authors.lastname: Lutter
authors.forename: M
authors.initials: M
authors.lastname: Frey
authors.forename: B
authors.initials: B
authors.lastname: Saurbier
authors.forename: E
authors.initials: E
authors.lastname: Nitzsche
authors.forename: S
authors.initials: S
authors.lastname: Hoegerle
authors.forename: M
authors.initials: M
authors.lastname: Brunner
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.forename: C
authors.initials: C
authors.lastname: Lutz
authors.forename: G
authors.initials: G
authors.lastname: Spillner
authors.forename: F
authors.initials: F
authors.lastname: Beyersdorf
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000295:instrumentation*; D016896:Treatment Outcome
vernacular_title: Behandlungsstrategien bei therapierefraktärer Angina pectoris: Transmyokardiale Laserrevaskularisation.