A DECADE OF EXPERIENCE IN APPLICATION OF TRANSMYOCARDIAL LASER REVASCULARIZATION IN COMBINATION WITH AORTOCORONARY SHUNTING

Abstract

Objective: to study the security and the effect of transmyocardial laser revascularization in combination with aortocoronary shunting in patience with diffuse coronary artery disease.Materials and methods: the study compared the results of surgical treatment in patients with diffuse distal coronary artery disease in the period from 2007 to 2013. Patients were divided into two groups, the first group consisted of patients who underwent CABG in combination with TMLR (n-60), the second group includes patients who underwent isolated CABG (n-46). According to the initial demographic data and comorbidity, the groups were not significantly different from each other. Subsequent observation (on average 7, 5±0, 9 years) included rating of survival and return of angina. Results: remote mortality during the observation period in the first group was 7, 6 % (n = 4), and in the second group — 18, 9 % (n = 7). In both groups the functional class of angina pectoris significantly decreased, however, in the first group this tendency was more expressed (exertional angina I EF in the CABG + TMLR group have 54 (90 %) patients, in the second group — 33 (71,7 %), p = 0,02. Conclusions: transmyocardial laser revascularization in combination with aortocoronary shunting in high-risk patients with diffuse atherosclerotic lesions of the coronary arteries contributed to an increase in exercise tolerance, reduced symptoms, and provided an acceptable quality of life in the long term.

Keywords

• ischemic heart disease, transmyocardial revascularization, coronary bypass, diffuse coronary artery atherosclerosis