Contrast-echocardiography: confirmation of patency of laser channels after transmyocardial laser revascularization.
OBJECTIVE
Apart from casuistic autopsy results there is no long-term evidence for channel perfusion after transmyocardial laser revascularization in humans.


RESULTS
Fifteen consecutive patients aged 63+/-17 years were investigated 71+/-15 days after coronary artery bypass surgery and/or transmyocardial revascularization with 13-37 (20+/-5) channels (CO(2) laser, 40 J/pulse). Echocardiography was performed after injection of 6 ml echo contrast medium into left ventricular cavity and after injection of 3 ml contrast medium into the left main coronary artery. In five patients with additional bypass surgery to the same region, we also injected 3 ml contrast medium into bypass graft. We could prove in 10 of 15 patients (67%) one or two laser channels in the apical left ventricular myocardium. Channels were perfused exclusively during systole. During following heart cycles myocardium was opacified up to a mean width of 1.4+/-0.4 cm, a mean depth of 0.71+/-0.1cm, and a mean area of 1.0+/-0.6 cm(2). Contrast medium was washed out via coronary venous system in 9+/-8 systoles.


CONCLUSIONS
This is the first clinical evidence of long-term laser-channel patency in humans showing perfused myocardium via left ventricular cavity.
Reuthebuch
O
O
Department of Cardio-Vascular Surgery, Unispital Zürich, Zürich, Switzerland. oliver.reuthebuch@chi.usz.ch
Berwing
K
K
Roth
M
M
Klövekorn
W-P
WP
Bauer
E P
EP
D003287:Contrast Media; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods
D003287:Contrast Media