Horvath Keith A
Division of Cardiothoracic Surgery, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Heart Surg Forum. 2002;5(1):33-9; discussion 39-40.
Over 6,000 patients worldwide have undergone transmyocardial laser revascularization (TMR) for the treatment of myocardial ischemia due to end-stage coronary artery disease since 1990. Four prospective randomized controlled trials have reported their results in comparing TMR to maximum medical therapy. All of the trials demonstrated that TMR provided significant relief of angina when compared to medical management. Additional objective data in the form of exercise tolerance and myocardial perfusion scanning was used to support the symptomatic improvement. Recent reports of the failure of percutaneous transmyocardial laser revascularization (PMR) to provide angina relief greater than that seen in a placebo group underscore the need for better understanding of TMR. While all of these trials are similar, they are not identical and this review provides an update and comparison of the results.
自1990年以来，全球已有6000多名患者接受了经心肌激光血运重建术（TMR），用于治疗终末期冠状动脉疾病所致的心肌缺血。四项前瞻性随机对照试验报告了比较TMR与最佳药物治疗的结果。所有试验均表明，与药物治疗相比，TMR能显著缓解心绞痛。以运动耐量和心肌灌注扫描形式提供的额外客观数据，被用于支持症状改善。近期关于经皮心肌激光血运重建术（PMR）未能比安慰剂组更有效缓解心绞痛的报告，凸显了更好地理解TMR的必要性。虽然所有这些试验相似，但并不完全相同，本综述提供了结果的更新和比较。
