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Author Horvath, Keith A.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Wiley
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Surgery & related medical specialties ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Nervous System Diseases ♦ Cardiovascular Diseases ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Surgical Procedures, Operative ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Circulatory and Respiratory Physiological Phenomena ♦ Biological Sciences
Subject Keyword Discipline Cardiology ♦ Discipline Surgery ♦ Coronary Disease ♦ Surgery ♦ Laser Therapy ♦ Methods ♦ Myocardial Revascularization ♦ Angina Pectoris ♦ Animals ♦ Coronary Artery Bypass ♦ Humans ♦ Minimally Invasive Surgical Procedures ♦ Neovascularization, Physiologic ♦ Randomized Controlled Trials As Topic ♦ Treatment Outcome ♦ Journal Article ♦ Review
Abstract It has been almost a decade since transmyocardial laser revascularization (TMR) was approved for clinical use in the United States. The safety of TMR was demonstrated initially with nonrandomized studies in which TMR was used as the only treatment for patients with severe angina. TMR efficacy was proven after multiple randomized controlled trials. These revealed significant angina relief compared to maximum medical therapy in patients with diffuse coronary disease not amenable to conventional revascularization. In light of these results, TMR has been used as an adjunct to coronary artery bypass grafting (CABG). By definition, patients treated with this combined therapy have more severe coronary disease and comorbidities that are associated with end-stage atherosclerosis. Combination CABG + TMR has resulted in symptomatic improvement without additional risk. The likely mechanism whereby TMR has provided benefit is the angiogenesis engendered by the laser-tissue interaction. Improved perfusion and concomitant improvement in myocardial function have been observed post-TMR. Additional therapies to enhance the angiogenic response include combining TMR with stem cell-based treatments, which appear to be promising future endeavors.
Description Country affiliation: United States
Author Affiliation: Horvath KA ( Cardiothoracic Surgery Research, National Heart, Lung and Blood Institute/NIH, Bethesda, Maryland 20892, USA. khorvath@nih.gov)
ISSN 08860440
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2008-05-01
Publisher Place United States
e-ISSN 15408191
Journal Journal of Cardiac Surgery
Volume Number 23
Issue Number 3


Source: WHO-Global Index Medicus