激光直接心肌隧道术治疗缺血性心脏病实验研究

DirectTraasmyocardiatLaserChaaoelsinTreatmentoflschemicHeartDisease

研究钬激光和高功率二氧化碳激光在急性缺血心肌上产生穿透室壁全层隧道对心肌缺血的保护作用。以２０ｋｇ体重Ｙｏｒｋｓｈｉｒｅ猪分为钬激光组（７只），ＣＯ２激光组（１０只）及对照组（８只）进行实验。结果表明：钬激光无法产生满意的激光隧道，但有诱发新生血管形成的可能；高功率二氧化碳激光能够产生理想的激光隧道，对急性缺血心肌提供血液灌注，并可避免室颤的发生。但远期通畅仍有待解决。

Aim:Tostudythepossibilityoftransmyocardiallaserchannelsinsalvaging.yocardialischemia.Method,Twenty-fiveYorkshireporcineweredividedintothreegroups,control,Ho,YAGlaserandHeartLaser(highpowerCO.laser)group.Firstofall,theacuteischemiaofleftcircumflexareawasproducedbyligatingleftcircumflexcoronaryarteryafteritsfirstntarginalbranch.lnlaser-treatedgroups,abouttwentytransmurallaserchannelswerecreatedintheischemicmyocardium.Theevalua-tionofepicardialechocardiographybeforeandafterinfarction,andoneorfourweekslaterwithAlbunexechoimaging,X-ray,microfilinjection,andpathologywereperformed.AlloftheseresultsshowedthattheHo,YAGlaserchannelsfailedtoopacifyafterfourweeksanditisnotasuit.bletoolforthispur-pose.Heartlaserproducedidealtransmuralchannelswithbloodperfusionfromleftventricleshortlyaf-terthechannelsweremade.However,thesechannelswereabletoopenonlypartiallyoneweeklater.Thus,thekeyissueishowtokeeptheselaser-inducedchannelsopenforlongerperiodoftime.