Okada M
Department of Surgery, Division II, Kobe University School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, Kobe 650-0017, Japan.
Ann Thorac Cardiovasc Surg. 1998 Jun;4(3):119-24.
Much attention has been paid to surgical intervention for those patients with small branches or diffuse stenotic lesions of the coronary arteries, for whom coronary artery bypass grafting can not be carried out at all. For resolving these problems, we have planned to supply arterial blood from the left ventricular cavity into the ischemic myocardium through laser channels created by laser into the myocardium. It was obviously recognized that arterial blood could be hemodynamically supplied from the left ventricular cavity into the ischemic myocardium. In trials on dogs, laser channels 0.2 mm in diameter have been shown microscopically to be patent even 3 years after TMLR. Thus, this procedure could be used as a new method of transmyocardial revascularization. Subsequently, TMLR was applied in a 55-year-old male patient with severe angina pectoris who had undergone pericardiectomy 7 years before. He is still alive 12 years after TMLR. This patient was the first successful clinical case treated by TMLR alone, in the world.
对于那些冠状动脉有小分支或弥漫性狭窄病变、根本无法进行冠状动脉搭桥术的患者，外科干预已受到广泛关注。为了解决这些问题，我们计划通过激光在心肌中创建的通道，将左心室腔的动脉血供应到缺血心肌中。很明显，动脉血可以通过血流动力学从左心室腔供应到缺血心肌中。在对狗的试验中，直径0.2毫米的激光通道在经心肌激光血运重建术（TMLR）后3年，显微镜下仍显示通畅。因此，该手术可作为一种新的心肌血运重建方法。随后，TMLR应用于一名55岁的男性严重心绞痛患者，该患者7年前接受了心包切除术。TMLR术后12年他仍然活着。该患者是世界上首例仅通过TMLR治疗成功的临床病例。
