[Transmyocardial laser revascularization].
OBJECTIVE
The study looked at our results with transmyocardial laser revascularization. We also tried to ascertain the role of TMLR in current cardiothoracic surgical practice.


METHODS
Twenty patients underwent TMLR at IKEM Praha in a period from 1999 to 2007. Patients were categorized into two separate groups. The first included patients who had TMLR as a single procedure. Second group comprised patients who underwent combined TMLR and direct bypass revascularization. Outcome measures were reduction of angina, improvements in exercise tolerance and left ventricular systolic function.


RESULTS
Improvement in CCS classification of two and more classes has been achieved in almost half the patients who underwent TMLR combined with CABG, but only in 20% of patients after isolated TMLR. There was no change in left ventricular systolic function either in group of patients after TMLR or in group with hybrid procedure. There was also no change detected in myocardial perfusion in thallium scintigraphy studies.


CONCLUSIONS
The study confirmed that TMLR has minimal perioperative complication rate and is safe. On the other hand our results failed to demonstrate any significant improvement in quality of life following TMLR. In our opinion TMLR should be reserved for symptomatic patients in CCS IV class when all other conventional treatment options have been exhausted.
Urban
M
M
Klinika kardiovaskulární chirurgie IKEM, Praha 4. marian.urban@ikem.cz
Pirk
J
J
Szárszoi
O
O
Vodicková
J
J
Netuka
I
I
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D013318:Stroke Volume