Acute effects of transmyocardial laser revascularization on left-ventricular function: an haemodynamic and echocardiographic study.

Details

Serval ID
serval:BIB_6EE31406BBD2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute effects of transmyocardial laser revascularization on left-ventricular function: an haemodynamic and echocardiographic study.
Journal
The Thoracic and cardiovascular surgeon
Author(s)
Mueller X.M., Bettex D., Tevaearai H.T., von Segesser L.K.
ISSN
0171-6425
Publication state
Published
Issued date
1998
Peer-reviewed
Oui
Volume
46
Number
3
Pages
126-9
Language
english
Notes
Publication types: Comparative Study ; Journal Article - Publication Status: ppublish
Abstract
While the lesions produced by transmyocardial laser revascularisation (TMLR) induce scar formation, it is important to determine whether this procedure can be deleterious for the left-ventricular function, which is already impaired by the underlying ischaemic process in some patients. Ten channels were drilled in the left lateral wall of the hearts of ten pigs (mean weight, 61 +/- 8.2kg) with a Holmium:YAG laser. Haemodynamic measurements and echocardiographic assessment of left-ventricular function were performed before the TMLR procedure, 5 and 30 min after, and lastly after 5 min of pacing at a rate increased by 30% of the baseline value. Echocardiographic assessment was in the short axis at the level of the laser channels, and included left-ventricular ejection fraction and segmental wall motility of the lasered area (scale 0-3:0 = normal 1 = hypokinesia, 2 = akinesia, 3 = dyskinesia). Values at 5 and 30 min were compared with baseline values; the difference was considered significant if p < 0.05. Haemodynamical values were stable throughout all the procedures. The ejection fraction showed a slight but significant decrease 5 min after the creation of the channels (60.4 +/- 6.8% vs 54 +/- 7.6%, p=0.02) and recovered at 30min. The segmental motility score of the involved areas increased to 1 after 5 min in five animals, and came back to 0 at 30 min except in one animal. Even with pacing no segmental dysfunction occurred. The reversibility of the segmental hypokinesia induced by TMLR, as well as the absence of pace-induced dysfunction 30 min after the procedure strongly suggest the inocuity of TMLR in this experimental set-up.
Keywords
Animals, Cicatrix, Disease Models, Animal, Echocardiography, Hemodynamics, Laser Therapy, Lasers, Myocardial Revascularization, Reference Values, Statistics, Nonparametric, Swine, Ventricular Function, Left
Pubmed
Web of science
Create date
14/02/2008 14:17
Last modification date
20/08/2019 14:28
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