Effects of transmyocardial laser revascularization using a prototype pulsed CO2 laser on contractility and perfusion of chronically ischemic myocardium in a porcine model

Yasmin Wadia, Ali Khaki, Michio Kajitani, Yoshiki Mori, Timothy Irvine, David Sahn, Michael Yessik, Deborah Bahlman, Anthony Furnary, Kenton Gregory

Research output: Contribution to journalConference article

Abstract

The purpose of this study was to test a new prototype pulsed CO2 laser to be used for transmyocardial laser revascularization (TMR). We want to determine whether it can reduce thermal damage and mitigate induced ischemia with improvement in contractile reserve of the heart as evidenced by contrast echocardiography at rest and under dobutamine stress. TMR is an emerging surgical strategy for treatment of myocardial ischemia not amenable to conventional percutaneous or surgical revascularization. Eleven pigs underwent ameroid occluder placement on the origin of the circumflex coronary artery. Six weeks later occlusion of the circumflex coronary artery was documented. TMR was then done on ten pigs using a prototype pulsed CO2 laser that delivered 8-12 joules energy in 1.5 ms with a spot size of 1 mm. Six weeks after TMR the pigs were restudied and sacrificed. The animals developed significant ischemia after six weeks of ameroid occlusion, at rest (p = 0.01) and at peak stress (p = 0.004). Wall motion for the ischemic segments improved significantly six weeks after TMR at peak stress (p = 0.02). TMR results in an improvement in wall motion in our model of chronic ischemia and improves WMSI significantly during induced stress than at rest.

Original languageEnglish (US)
Pages (from-to)296-307
Number of pages12
JournalProceedings of SPIE - The International Society for Optical Engineering
Volume3590
DOIs
StatePublished - 1999
EventProceedings of the 1999 Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems IX - San Jose, CA, USA
Duration: Jan 23 1999Jan 24 1999

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics
  • Computer Science Applications
  • Applied Mathematics
  • Electrical and Electronic Engineering

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