Evaluation of myocardial perfusion and left ventricular function six months after percutaneous transmyocardial laser revascularization: comparison of two Ho-YAG laser systems with the same wavelength, but different energy delivery and navigation systems.
OBJECTIVE
Myocardial perfusion and left ventricular function (LVF) were assessed after percutaneous transmyocardial laser revascularization (PTMR) in patients not amenable to conventional revascularization, with a comparison of two laser systems.


METHODS
PTMR was performed with an Eclipse laser in 15 patients, and with a Biosense DMR in 10 patients. (201)Thallium scintigraphy, coronary angiography, and ventriculography were performed at baseline and at the 7.5+/-4.3-month follow-up. All patients in the Biosense DMR group and 10 in the Eclipse group underwent NOGA mapping before PTMR and after follow-up.


RESULTS
The event-free survival rates were comparable, and the angina scores of all patients improved significantly, but more so in the Biosense DMR group than in the Eclipse group (1.2+/-1.1 vs. 2.3+/-0.9, P < 0.05). Both, the electrical activity assessed by NOGA mapping and the normalized (201)thallium uptake at redistribution improved significantly in the treated segments after Biosense DMR, while the global LVF decreased insignificantly in the Eclipse group.


CONCLUSIONS
PTMR resulted in significant improvements in the clinical symptoms, but the electrical activity improved only in the Biosense DMR group, without transforming to a better LVF.
Strehblow
Christoph
C
Division of Cardiology, University of Vienna Medical Center, Vienna, Austria.
Gyöngyösi
Mariann
M
Khorsand
Aliasghar
A
Sperker
Wolfgang
W
Gatterer
Melanie
M
Graf
Senta
S
Sochor
Heinz
H
Glogar
Dietmar
D
D000368:Aged; D018780:Body Surface Potential Mapping; D003324:Coronary Artery Disease / Q000628:therapy*; D003326:Coronary Circulation / Q000528:radiation effects*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000502:physiology; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000379:methods; D009204:Myocardial Revascularization / Q000379:methods*; D011827:Radiation; D013238:Stereotaxic Techniques; D016019:Survival Analysis; D016277:Ventricular Function, Left / Q000528:radiation effects*