Okada M, Nakamura M
Department of Surgery, Kobe University School of Medicine, Japan.
J Clin Laser Med Surg. 1998 Aug;16(4):197-201. doi: 10.1089/clm.1998.16.197.
The number of patients with coronary artery disease has been increasing and several kinds of treatments have been performed to alleviate their conditions. In patients with small branches or diffuse stenotic lesions of the coronary arteries, on whom coronary artery bypass grafting and intracoronary intervention cannot be carried out, it has been shown possible to supply arterial blood from the left ventricular cavity to the ischemic myocardium through laser channels. Arterial blood can be supplied hemodynamically from the left ventricular cavity to the ischemic myocardium. In trials on dogs laser channels 0.2 mm in diameter have been found to be histologically patent even 3 years after transmyocardial laser revascularization (TMLR). Thus, this procedure could be used as an alternative method of transmyocardial revascularization. We used TMLR on a 55-year-old male patient with severe angina pectoris who had undergone pericardiectomy 7 years ago. He is still alive more than 12 years after TMLR. This patient was among the first successful clinical cases in the world treated by TMLR alone. Therefore, this procedure should be recommended for the patients with end-stage coronary artery disease.
冠心病患者的数量一直在增加，并且已经实施了多种治疗方法来缓解他们的病情。对于冠状动脉小分支或弥漫性狭窄病变的患者，无法进行冠状动脉旁路移植术和冠状动脉内介入治疗，已经证明可以通过激光通道从左心室腔向缺血心肌供应动脉血。动脉血可以通过血流动力学从左心室腔供应到缺血心肌。在对狗的试验中，发现直径0.2毫米的激光通道在经心肌激光血运重建术（TMLR）后3年组织学上仍保持通畅。因此，该手术可作为经心肌血运重建的替代方法。我们对一名55岁的男性严重心绞痛患者进行了TMLR，该患者7年前接受了心包切除术。TMLR术后12年多他仍然活着。该患者是世界上首例仅通过TMLR成功治疗的临床病例之一。因此，对于终末期冠心病患者，应推荐这种手术。
