Transmyocardial revascularization with a carbon dioxide laser in patients with end-stage coronary artery disease

Article Abstract:

Transmyocardial revascularization using a carbon dioxide laser may be beneficial in some patients with coronary artery disease who cannot be treated with angioplasty or coronary bypass surgery. This procedure involves using a laser to make small channels in the heart muscle to improve blood flow. Researchers randomly assigned 192 patients with angina to receive this procedure or treatment with drugs. One year later, 72% of those treated with the laser had improved, compared to 13% of the other group. Only 2% had to be hospitalized for angina compared to 69% of those who received drug treatment. One-year survival rates were 85% and 79%, respectively.

Health aspects, Myocardial revascularization, Angina pectoris, Carbon dioxide lasers

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Myocardial revascularization - bypass surgery or angioplasty?

Article Abstract:

Patients with coronary artery disease that affects more than one artery should be treated with bypass surgery especially if they are diabetic. The 1996 publication of the Bypass Angioplasty Revascularization Investigation (BARI) revealed that patients with multivessel disease had a slightly better survival rate if they received bypass surgery rather than angioplasty. This was especially true in diabetics. This probably occurred because bypass surgery improves the blood supply to the heart more completely than angioplasty. Angioplasty is still an acceptable alternative in those who cannot have surgery.

Editorial

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Five-year clinical and functional outcome comparing bypass surgery and angioplasty in patients with multivessel coronary disease: a multicenter randomized trial

Article Abstract:

Patients with coronary artery disease who have angioplasty appear to have similar outcomes as those who have bypass surgery. Researchers participating in the Bypass Angioplasty Revascularization Investigation (BARI) followed 1,829 patients with coronary artery disease who had either angioplasty or bypass surgery for five years. Initially, those who had angioplasty had more episodes of angina but this difference narrowed over time. Most quality of life measures were similar in both groups. However, over half the angioplasty patients required additional angioplasty compared to 6% of the bypass patients.

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