准分子激光与二氧化碳经心肌激光血运重建术：对局部左心室功能和灌注的影响。

Excimer versus carbon dioxide transmyocardial laser revascularization: effects on regional left ventricular function and perfusion.

作者信息

Martin J S, Sayeed-Shah U, Byrne J G, Danton M H, Flores K Q, Laurence R G, Cohn L H

机构信息

Division of Cardiac Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

出版信息

Ann Thorac Surg. 2000 Jun;69(6):1811-6. doi: 10.1016/s0003-4975(00)01235-2.

DOI:10.1016/s0003-4975(00)01235-2

PMID:10892928

Abstract

BACKGROUND

Transmyocardial laser revascularization (TMR) has been established with the carbon dioxide (CO2) laser. The largely unstudied excimer laser creates channels through chemical bond dissociation instead of thermal ablation, thereby avoiding thermal injury. We sought to compare the effects of CO2 and excimer TMR in a porcine model of chronic ischemia.

METHODS

Pigs underwent ameroid constrictor placement on the circumflex artery to create chronic ischemia. TMR was performed with CO2 (n = 8) or excimer (n = 8) laser 6 weeks later; controls (n = 7) had ameroid placement only. Regional myocardial blood flow (RMBF), determined by radioactive microspheres, and regional myocardial function, determined by percent segmental shortening (%SS), were assessed 18 weeks after ameroid placement.

RESULTS

Values are mean +/- SD. In the ischemic zone, RMBF (mL/min/g) was improved in the CO2 (0.73 +/- 0.19) and excimer (0.78 +/- 0.22) groups when compared with controls (0.55% +/- 0.12%, p < 0.05). %SS was also improved in the CO2 (15.2% +/- 5.5%) and excimer (15.3% +/- 5.1%) groups when compared with controls (8.0% +/- 4.2%, p < 0.05).

CONCLUSIONS

Excimer and CO2 TMR significantly improve RMBF and regional function in this porcine model of chronic myocardial ischemia despite fundamentally different tissue interactions.

摘要

背景

经皮心肌激光血运重建术（TMR）已通过二氧化碳（CO2）激光得以确立。而准分子激光在很大程度上尚未得到充分研究，它通过化学键解离而非热消融来形成通道，从而避免热损伤。我们试图在慢性缺血的猪模型中比较CO2和准分子TMR的效果。

方法

猪接受在冠状动脉回旋支上放置阿梅罗伊德缩窄环以造成慢性缺血。6周后用CO2激光（n = 8）或准分子激光（n = 8）进行TMR；对照组（n = 7）仅放置阿梅罗伊德缩窄环。在放置阿梅罗伊德缩窄环18周后，通过放射性微球测定局部心肌血流量（RMBF），并通过节段缩短百分比（%SS）测定局部心肌功能。

结果

数值为平均值±标准差。在缺血区，与对照组（0.55%±0.12%，p < 0.05）相比，CO2组（0.73±0.19）和准分子激光组（0.78±0.22）的RMBF（毫升/分钟/克）有所改善。与对照组（8.0%±4.2%，p < 0.05）相比，CO2组（15.2%±5.5%）和准分子激光组（15.3%±5.1%）的%SS也有所改善。