title: Late angiograms ten years after transmyocardial laser revascularization.
abstract: We present the angiograms of a patient after transmyocardial laser revascularization (TMR), which were performed 10 years before by the application of holmium laser pulses. Thirteen years before the TMR procedure, the patient underwent coronary artery bypass graftings complicated by graft occlusion with no longer possibility of direct revascularization. Then, refractive angina required an alternative approach for symptom relief as the indirect revascularization by the application of the holmium laser pulses. Interestingly, the late angiograms, taken when the patient suffered from effort dyspnea for ongoing left ventricular dysfunction, showed a network of small vessels (absent before the TMR procedure) that supplies blood to the heart with no flow through the coronary arteries because of their complete occlusion. This is a historical presentation of the results of TMR to understand the effects of the indirect revascularization on the blood circulation through the heart over the long-term follow-up.
authors.affiliation: Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy. fabrisans@katamail.com
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sansone
authors.forename: Guglielmo Mario Actis
authors.initials: GM
authors.lastname: Dato
authors.forename: Edoardo
authors.initials: E
authors.lastname: Zingarelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Punta
authors.forename: Francesco
authors.initials: F
authors.lastname: Parisi
authors.forename: Pier Giuseppe
authors.initials: PG
authors.lastname: Forsennati
authors.forename: Roberto
authors.initials: R
authors.lastname: Flocco
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Bardi
authors.forename: Stefano Del
authors.initials: SD
authors.lastname: Ponte
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casabona
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D003097:Collateral Circulation; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003326:Coronary Circulation; D017809:Fatal Outcome; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012086:Reoperation; D013997:Time Factors; D057769:Transmyocardial Laser Revascularization; D016896:Treatment Outcome