Histologic analysis of transmyocardial channels: comparison of CO2 and holmium:YAG lasers.
Publication/Presentation Date
8-1-1997
Abstract
BACKGROUND: Transmyocardial laser revascularization using different lasers is being tested in the treatment of refractory angina. We conducted comparative analysis of the acute and chronic myocardial effects of these different lasers.
METHODS: Transmyocardial channels were made in normal dog hearts with either a holmium:yttrium-aluminum garnet or a CO2 laser. Channels were examined histologically 6 to 24 hours, 2 to 3 weeks, and 6 weeks after creation.
RESULTS: Regardless of the laser source, the channels were occluded by thrombus within 6 to 24 hours. Subsequently, organization and neovascularization of the channel region occurred. Thermoacoustic damage was initially greater with the holmium:yttrium-aluminum garnet laser, but the channel appearances were indistinguishable from those made with the CO2 laser by 6 weeks.
CONCLUSIONS: Histologically, the myocardial effects of the CO2 and holmium:yttrium-aluminum garnet lasers are similar and differ predominantly in the amount of acute thermoacoustic injury. Channels are rapidly occluded by thrombus and are replaced by neovascularized collagen. This suggests that the physiologic effects of these two lasers may be similar and that mechanisms other than blood flow through chronic patent channels should be considered as contributing to the clinical benefits observed with this procedure.
Volume
64
Issue
2
First Page
466
Last Page
472
ISSN
0003-4975
Published In/Presented At
Fisher, P. E., Khomoto, T., DeRosa, C. M., Spotnitz, H. M., Smith, C. R., & Burkhoff, D. (1997). Histologic analysis of transmyocardial channels: comparison of CO2 and holmium:YAG lasers. The Annals of thoracic surgery, 64(2), 466–472. https://doi.org/10.1016/S0003-4975(97)00519-5
Disciplines
Medicine and Health Sciences
PubMedID
9262595
Department(s)
Department of Pathology and Laboratory Medicine
Document Type
Article