Long-term outcome of cardiac allograft vasculopathy treated by transmyocardial laser revascularization: early rewards, late losses.
Transmyocardial laser revascularization (TLR) was initially touted as a promising therapeutic alternative for tackling the growing problem of cardiac allograft vasculopathy in late heart transplant survivors. We first described 4- and 8-week observations of application of this surgical technique, in which we professed enthusiasm for TLR in providing symptomatic relief and in reducing ischemic burden. In this report, we present the long-term (24-month) impact of TLR on clinical outcome, channel patency, and recrudescence of ischemic burden. In the long term, surgical TLR provides neither consistent symptomatic improvement nor an ameliorative effect on the natural history of cardiac allograft vasculopathy.
Mehra
M R
MR
Ochsner Cardiomyopathy and Heart Transplantation Center, Ochsner Medical Institutions, New Orleans, LA, USA. mmehra@ochsner.org
Uber
P A
PA
Prasad
A K
AK
Park
M H
MH
Scott
R L
RL
McFadden
P M
PM
Van Meter
C H
CH
D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000473:pathology*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome