Isner J M, Michlewitz H, Clarke R H, Estes N A, Donaldson R F, Salem D N, Bahn I, Payne D D, Cleveland R J
Ann Thorac Surg. 1985 Mar;39(3):201-6. doi: 10.1016/s0003-4975(10)62576-3.
In selected patients, malignant ventricular tachyarrhythmias have been successfully abolished by excision of subendocardial arrhythmogenic foci. Likewise, in certain patients in whom restrictive cardiomyopathy is due to endocardial thickening, endocardial resection has resulted in hemodynamic improvement. The present study was designed to explore the utility, in vitro, of laser photoablation of pathologically thickened endocardium. Endocardial photoablation was easily accomplished regardless of etiological or anatomical variations using either the focused beam of a carbon dioxide laser or argon laser light delivered through a 200-microns optical fiber. Photoablation of areas as large as 3.9 X 1.3 cm was performed within 40 seconds. The extent or depth of endocardial photoablation could be limited to 2 mm2 in area or 1 mm in depth using either form of laser therapy. These in vitro results suggest that either carbon dioxide or argon laser phototherapy can be successfully applied to the surgical treatment of refractory arrhythmias and restrictive cardiomyopathy. Advantages of laser photoablation include speed and precision. Furthermore, laser photoablation obviates the difficulty associated with conventional techniques in establishing tissue planes.
在部分患者中，通过切除心内膜下致心律失常病灶，恶性室性心律失常已被成功消除。同样，在某些因心内膜增厚导致限制型心肌病的患者中，心内膜切除术已使血流动力学得到改善。本研究旨在探讨激光光凝病理增厚的心内膜在体外的效用。无论病因或解剖结构如何变化，使用二氧化碳激光的聚焦光束或通过200微米光纤传输的氩激光，心内膜光凝都能轻松完成。在40秒内可对面积达3.9×1.3厘米的区域进行光凝。使用任何一种激光治疗形式，心内膜光凝的范围或深度可限制在面积2平方毫米或深度1毫米。这些体外研究结果表明，二氧化碳或氩激光光疗均可成功应用于难治性心律失常和限制型心肌病的外科治疗。激光光凝的优点包括速度和精确性。此外，激光光凝避免了与传统技术在建立组织层面时相关的困难。
