CLINICAL STUDY OF TRANSMYOCARDIAL LASER REVASCULARIZATION TREATING CORONARY ARTERY DISEASE

Geng Zhao, Xianen Fa, De-guang Feng, S. Zhuang, David Zhang, Peiling Chu
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Abstract

Objective:To review the clinical experience of sole transmyocardial laser revascularization (TMLR) in treatment of coronary heart disease (CHD).Material and Methods:Three cases were all unstable angina,age was between 45~64 yearsold.Past medical history included 100% hypertension,prior AMI 33.3%.Left ventricular ejection fraction was between 0.57~0.62,FS 0.28~0.30,ECG and SPECT ( 99m Tc-MiBi) showed anterior and inferior wall ischemia.TMLR was performed on the beating heart via a left anterolaterial thoracotomy in the fifth intercoseal space.CO 2 laser mashine (Meiman HL-100) was used.Transmyocardial penetration number was between 8~14 in ischemic zone.Results:The perioperative mortality was.There was not post-operative complication,such as AMI,left ventricular failure.Angina were all not existence.Mean recovery time was two weeks.Conclusion:Sole TMLR is a safe and effective procedure for treatment of end stage CHD especially for not amenable to PTCA or CABG.The indication for TMLR should be extended in our country.
经心肌激光血管重建术治疗冠状动脉疾病的临床研究
目的:总结单纯经心肌激光血管重建术(TMLR)治疗冠心病的临床经验。材料与方法:3例均为不稳定型心绞痛,年龄45~64岁。既往病史包括100%高血压,既往AMI 33.3%。左室射血分数0.57~0.62,FS 0.28~0.30,心电图和SPECT (99m Tc-MiBi)显示前、下壁缺血。TMLR在跳动的心脏上通过左前胸廓切开术在第五肋间间隙进行。采用co2激光机(Meiman HL-100)。缺血区心肌穿透数为8~14个。结果:围手术期死亡率为。无AMI、左心室衰竭等术后并发症。心绞痛都不存在。平均恢复时间为2周。结论:单纯TMLR是一种安全有效的治疗终末期冠心病的方法,尤其适用于不适合PTCA或CABG的患者。我国应扩大TMLR的适应症。
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期刊介绍: Chinese Journal of Postgraduates of Medicine (founded in 1978, monthly) is one of the series of journals of the Chinese Medical Association (CMA) under the supervision of the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association (CMA) and Dalian Institute of Theoretical Medicine (DITM). It is a core journal of Chinese science and technology, a statistical source journal of Chinese scientific and technical papers, and a statistical source journal of China Academic Journal Impact Factor Annual Report. The journal adheres to the purpose of using continuing medical education and post training, highlights new theories, new knowledge, new methods and new technologies, and focuses on the combination of theory and practice, and the combination of popularisation and improvement. Main columns: Special tutorials, expert forums, clinical treatises, clinical experience, reviews and lectures, continuing medical education, teaching and research, advanced training forum, drugs and clinics, overview of progress, introduction of new technologies, imaging and clinics, lessons learnt, discussions and evaluations, case reports, discussions of clinical cases, conference proceedings, and domestic and international academic developments. The main target readers are clinical medical personnel in internal medicine, surgery, gynaecology, paediatrics and ophthalmology.
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