Transmyocardial revascularization devices: technology update

Bogdan A Kindzelski, Yifu Zhou, Keith A Horvath Cardiothoracic Surgery Research Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA Abstract: Transmyocardial laser revascularization (TMR) emerged as treatment modality for patients with diffuse corona...

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Autores principales:	Kindzelski BA, Zhou Y, Horvath KA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/53d181dec32e4b278ae3974f1021b560
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spelling	oai:doaj.org-article:53d181dec32e4b278ae3974f1021b5602021-12-02T02:35:27ZTransmyocardial revascularization devices: technology update1179-1470https://doaj.org/article/53d181dec32e4b278ae3974f1021b5602014-12-01T00:00:00Zhttp://www.dovepress.com/transmyocardial-revascularization-devices-technology-update-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470 Bogdan A Kindzelski, Yifu Zhou, Keith A Horvath Cardiothoracic Surgery Research Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA Abstract: Transmyocardial laser revascularization (TMR) emerged as treatment modality for patients with diffuse coronary artery disease not amendable to percutaneous or surgical revascularization. The procedure entails the creation of laser channels within ischemic myocardium in an effort to better perfuse these areas. Currently, two laser devices are approved by the US Food and Drug Administration for TMR – holmium:yttrium–aluminum–garnet and CO2. The two devices differ in regard to energy outputs, wavelengths, ability to synchronize with the heart cycle, and laser–tissue interactions. These differences have led to studies showing different efficacies between the two laser devices. Over 50,000 procedures have been performed worldwide using TMR. Improvements in angina stages, quality of life, and perfusion of the myocardium have been demonstrated with TMR. Although several mechanisms for these improvements have been suggested, evidence points to new blood vessel formation, or angiogenesis, within the treated myocardium, as the major contributory factor. TMR has been used as sole therapy and in combination with coronary artery bypass grafting. Clinical studies have demonstrated that TMR is both safe and effective in angina relief long term. The objective of this review is to present the two approved laser devices and evidence for the safety and efficacy of TMR, along with future directions with this technology. Keywords: laser, revascularization, angiogenesis, coronary artery diseaseKindzelski BAZhou YHorvath KADove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2015, Iss default, Pp 11-19 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Kindzelski BA Zhou Y Horvath KA Transmyocardial revascularization devices: technology update
description	Bogdan A Kindzelski, Yifu Zhou, Keith A Horvath Cardiothoracic Surgery Research Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA Abstract: Transmyocardial laser revascularization (TMR) emerged as treatment modality for patients with diffuse coronary artery disease not amendable to percutaneous or surgical revascularization. The procedure entails the creation of laser channels within ischemic myocardium in an effort to better perfuse these areas. Currently, two laser devices are approved by the US Food and Drug Administration for TMR – holmium:yttrium–aluminum–garnet and CO2. The two devices differ in regard to energy outputs, wavelengths, ability to synchronize with the heart cycle, and laser–tissue interactions. These differences have led to studies showing different efficacies between the two laser devices. Over 50,000 procedures have been performed worldwide using TMR. Improvements in angina stages, quality of life, and perfusion of the myocardium have been demonstrated with TMR. Although several mechanisms for these improvements have been suggested, evidence points to new blood vessel formation, or angiogenesis, within the treated myocardium, as the major contributory factor. TMR has been used as sole therapy and in combination with coronary artery bypass grafting. Clinical studies have demonstrated that TMR is both safe and effective in angina relief long term. The objective of this review is to present the two approved laser devices and evidence for the safety and efficacy of TMR, along with future directions with this technology. Keywords: laser, revascularization, angiogenesis, coronary artery disease
format	article
author	Kindzelski BA Zhou Y Horvath KA
author_facet	Kindzelski BA Zhou Y Horvath KA
author_sort	Kindzelski BA
title	Transmyocardial revascularization devices: technology update
title_short	Transmyocardial revascularization devices: technology update
title_full	Transmyocardial revascularization devices: technology update
title_fullStr	Transmyocardial revascularization devices: technology update
title_full_unstemmed	Transmyocardial revascularization devices: technology update
title_sort	transmyocardial revascularization devices: technology update
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/53d181dec32e4b278ae3974f1021b560
work_keys_str_mv	AT kindzelskiba transmyocardialrevascularizationdevicestechnologyupdate AT zhouy transmyocardialrevascularizationdevicestechnologyupdate AT horvathka transmyocardialrevascularizationdevicestechnologyupdate
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Transmyocardial revascularization devices: technology update

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