Cic edizioni internazionali
Il Giornale di Chirurgia

Transmyocardial laser revascularization. Personal experience

Original Article, 464 - 466
Tag this article
Full text HTML Full text PDF
Background. Indirect revascularization is a therapeutic approach in case of severe angina not suitable for percutaneous or surgical revascularization.
Transmyocardial revascularization (TMR) is one of the techniques used for indirect revascularization and it allows to create transmyocardial channels by a laser energy bundle delivered on left ventricular epicardial surface. Benefits of the procedure are related mainly to the angiogenesis caused by inflammation and secondly to the destruction
of the nervous fibers of the heart.
Patients and method. From September 1996 up to July 1997, 14 patients (9 males – 66.7%, mean age 64.8±7.9 years) underwent TMR. All patients referred angina at rest; Canadian Angina Class was IV in 7 patients (58.3%), III in 5 (41.7%). Before the enrollment, coronarography was routinely performed to find out the feasibility of Coronary
Artery Bypass Graft (CABG): 13 patients (91,6%) had coronary arteries lesions not suitable for direct revascularization; this condition was limited only to postero-lateral area in one patient submitted to combined TMR + CABG procedures.
Results. Mean discharge time was 3,2±1,3 days after surgery. All patients were discharged in good clinical conditions. Perfusion thallium scintigraphy was performed in 7 patients at a mean follow-up of 4±2 months, showing in all but one an improvement of perfusion defects.
Moreover an exercise treadmill improvement was observed in the same patients and all of them are in good clinical conditions, with significantly reduced use of active drugs.
Conclusion. Our experience confirms that TMR is a safe and feasible procedure and it offers a therapeutic solution in case of untreatable angina. Moreover, it could be a hybrid approach for patients undergoing CABGs in case of absence of vessels suitable for surgical approach in limited areas of the heart.

Vol XL (No. 4) 2019 July-August

  1. The widespread of Robot-Assisted Surgery: the urologist perspective
    Mearini E., Del Zingaro M., Boni A.
  2. Hyperbaric oxygen therapy in Plastic Surgery practice: case series and literature overview
    Bassetto F., Bosco G., Brambullo T., Kohlscheen E., Tocco Tussardi I., Vindigni V., Tiengo C.
  3. The ERAS Protocol is at the forefront of the peri-operative pathway in colorectal surgery: monocentric clinical study
    Cicardo G., Ursi P., Rossi V., Ceccarelli G., Di Matteo F.M., Panarese A., D'Andrea V.
  4. Retained sponges in abdomen: an analysis of the judgments of the Italian Supreme Court
    Gioia S., Lancia M., Cirocchi R., Suadoni F., Franceschetto L., Santoro A., Palumbo P., Boselli C., Barberini F., Covarelli P., Renzi C., Carlini L.
  5. Nasal flap or cutaneous grafting in basal cell cancer of the nose. Comparison of two reconstructive possibilities
    Vergine M., Frusone F., De Luca A., Aceti V., Marcasciano M., Amabile M.I., Monti M.
  6. Non small cell lung cancer metastasized to the breast and treated with modified radical mastectomy: a case report
    Grigoropoulos P., Mariolis-Sapsakos T., Karantonis I., Kaklamanos I., Karanasiou V., Zografos C.G., Chrysikos D.
  7. Importance of a careful clinical evaluation in the diagnosis of cystic pancreatic tumors
    Di Cataldo A., Bellavia N., Amico A., Latino R., Bosco D., Perrotti S.
  8. Mass of the neck: an extremely rare location of hydatid disease
    Siaperas P., Zoikas A., Ioannidis O., Karanikas I.
  9. Nuck canal cyst involving right femoral vein: management and therapy of a rare clinical case
    Leanza V., D'antoni S., Lo Presti V., Zanghì G., Vecchio R., Leanza G., Basile F.
  10. Small bowel occlusion after trans-abdominal preperitoneal hernia approach caused by barbed suture: case report and review of literature
    Sartori A., De Luca M., Clemente N., De Luca A., Scaffidi G., Piatto G., Noaro G., Campagnaro C.
  11. Bilateral overuse myositis ossificans of the triceps: report of an unusual case
    Georgoulis S., Koutserimpas C.
  12. Dual site intestinal perforation due to toothpick
    Ossola L., Galafassi J.
  13. A rare case of trichilemmal ovarian carcinoma. Case report and review of the literature
    Leanza V., Nobile V., Galvagno C., Di Grazia F.M., Palumbo M., Leanza G.
  14. Gossypiboma in abdomen: retained surgical gauze after a cesarean section
    Bilali V., Bilali S., Mitrushi A., Pirushi R., Nina H., Ktona E.
  15. Encapsulating peritoneal sclerosis: do not be too late for the right diagnosis! Case report and short literature review
    Sinagra E., Buscaglia F., Iacoponelli A., Sciumè C.
  16. Adrenalectomy for benign and malignant adrenal tumors. Experience from Misurata Cancer Center
    Wafa A., Ghellai A., Aboshnaf A., Elfagieh M., Juwid A.
  17. Left colon interposition for esophageal reconstruction after perforation by metal blades ingestion: a case report
    Bizzoca C., Pisicchio S., Torchia G., Vincenti L.
  18. An alternative management of a Littré hernia case: food for thought
    Schizas D., Katsaros I., Koliakos N., Ntomi V., Tsilimigras D.I., Moris D., Misiakos E.P., Zavras N., Bakopoulos A.
  19. Jejunal metastasis of Merkel cell carcinoma: case report
    Mancini S., Solinas L., Leone L., Battaglia B., Notarangelo M.G., Hassan R., Di Cosimo C., Angeloni R., Belardi A., Cosentino L., Bakacs A., Sagnotta A.
  20. CT-guided drainage with percutaneous approach as treatment of E. Faecalis post caesarean section severe abscess: case report and literature review
    Leanza V., Lo Presti V., Di guardo F., Leanza G., Palumbo M.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Transmyocardial laser revascularization. Personal experience
    Sansone F., Actis Dato G.M., Zingarelli E., Punta G., Parisi F., Forsennati P.G., Flocco R., Bardi G.L., Del Ponte S., CAsabona R.