Direct CO2 laser “revascularization” of the myocardium

✍ Scribed by Rodney Landreneau; Weerachai Nawarawong; Harold Laughlin; Joseph Ripperger; Olen Brown; Wayne McDaniel; Daniel McKown; Jack Curtis

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 802 KB
• Volume: 11
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.1900110109

✦ Synopsis

Evidence of regional myocardial perfusion and contractile function after direct CO, laser myocardial revascularization (DLR) is lacking. We examined myocardial segment shortening, adenine nucleotide concentrations, and regional blood flow after DLR of the left anterior descending coronary artery (LAD) distribution before and after its proximal ligation in seven anesthetized conditioned dogs. Sonomicrometry assessed myocardial fiber shortening and radioactive microspheres were used to estimate baseline regional blood flows. Cardiopulmonary bypass was followed by cardioplegia arrest. Laser channels (1 mm diameter) were made every 3 to 5 mm in the LAD region with an 80 watt Lasersonics CO, unit. Bypass was terminated, the LAD occluded, and parameters reassessed. Core samples of myocardium from the lased LAD and control circumflex area were taken to assess adenine nucleotides. After occlusion, LAD distribution blood flow and myocardial shortening were reduced to pre-lasing ischemic controls. Adenine nucleotides were reduced in the LAD region relative to the control CMX area. DLR cannot be relied upon to acutely revascularize the ischemic myocardium.