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Titolo:
Short- and intermediate-term clinical outcomes from direct myocardial laser revascularization guided by biosense left ventricular electromechanical mapping
Autore:
Kornowski, R; Baim, DS; Moses, JW; Hong, MK; Laham, RJ; Fuchs, S; Hendel, RC; Wallace, D; Cohen, DJ; Bonow, RO; Kuntz, RE; Leon, MB;
Indirizzi:
Washington Hosp Ctr, Cardiovasc Res Fdn, Inst Cardiovasc Res, Washington, DC 20010 USA Washington Hosp Ctr Washington DC USA 20010 Res, Washington, DC 20010 USA Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 r, Boston, MA 02215 USA Lenox Hill Hosp, Cardiovasc Res Fdn, New York, NY 10021 USA Lenox Hill Hosp New York NY USA 10021 asc Res Fdn, New York, NY 10021 USA Northwestern Univ, Med Ctr, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 iv, Med Ctr, Chicago, IL 60611 USA
Titolo Testata:
CIRCULATION
fascicolo: 10, volume: 102, anno: 2000,
pagine: 1120 - 1125
SICI:
0009-7322(20000905)102:10<1120:SAICOF>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; TRANSMYOCARDIAL REVASCULARIZATION; REFRACTORY ANGINA; MEDICAL THERAPY;
Keywords:
myocardium; lasers; ischemia; revascularization; angina;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Kornowski, R Washington Hosp Ctr, Cardiovasc Res Fdn, Inst Cardiovasc Res,110 Irving St NW,4B-1, Washington, DC 20010 USA Washington Hosp Ctr 110 Irving St NW,4B-1 Washington DC USA 20010
Citazione:
R. Kornowski et al., "Short- and intermediate-term clinical outcomes from direct myocardial laser revascularization guided by biosense left ventricular electromechanical mapping", CIRCULATION, 102(10), 2000, pp. 1120-1125

Abstract

Background-Direct myocardial revascularization (DMR) has been examined as an alternative treatment for patients with chronic refractory myocardial ischemic syndromes who are not candidates for conventional coronary revascularization,Methods and Results-We used left ventricular electromagnetic guidance in 77 patients with chronic refractory angina (56 men, mean age 61+/-11 years, ejection fraction 0.48+/-0.11) to perform percutaneous DMR with an Ho:YAG laser at 2 J/pulse, Procedural success (laser channels placed in prespecified target zones) was achieved in 76 of 77 patients with an average of 26+/-10 channels (range Ii to 50 channels). The rate of major in-hospital cardiacadverse events was 2.6%, with no deaths or emergency operations, 1 patientwith postprocedural pericardiocentesis, and 1 patient with minor embolic stroke. The rate of out-of-hospital adverse cardiac events (up to 6 months) was 2.6%, with 1 patient with myocardial infarction and I patient with stroke. Exercise duration after DMR increased from 387+/-179 to 454+/-166 seconds at 1 month and to 479+/-161 seconds at 6 months (P=0.0001). The time to onset of angina increased from 293+/-167 to 377+/-176 seconds at 1 month and to 414+/-169 seconds at 6 months (P=0.0001). Importantly, the time to ST-segment depression (greater than or equal to 1 mm) also increased from 327+/-178 to 400+/-172 seconds at 1 month and to 436+/-175 seconds at 6 months (P=0.001). Angina (Canadian Cardiovascular Society classification) improvedfrom 3.3+/-0.5 to 2.0+/-1.2 at 6 months (P<0.001). Nuclear perfusion imaging studies with a dual-isotope technique, however, showed no significant improvements at 1 or 6 months. Conclusions-Percutaneous DMR guided by left ventricular mapping is feasible and safe and reveals improved angina and prolonged exercise duration for up to a 6-month follow-up.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/04/20 alle ore 07:54:05