CO_2激光心肌血管重建术治疗冠心病

Preliminary report on transmyocardial revascularization by CO_2 laser

目的 总结 1999年 3月至 12月完成的 30例激光心肌血管重建术 (TMLR)的经验。方法 将 30例患者分为冠状动脉旁路移植术 (CABG) +TMLR组 2 0例和单纯TMLR组 10例。CABG +TMLR组采用正中切口 ,先行CABG ,再行TMLR ,平均搭桥 2 .3根 ,打孔 8.2个 ;TMLR组 10例 ,左前外侧第 5肋间进胸 ,行TMLR ,平均打孔 31.7个。结果 全组无手术死亡 ,术后 1个月内心绞痛均消失 ,3个月后 ,CABG +TMLR组 (1例 ) 5 %心绞痛复发 ,同位素示缺血区消失 ,TMLR组 (7例 ) 70 %心绞痛减轻 ,同位素示缺血区缩小。结论 TMLR能缓解心绞痛 。

Objective To report the results of 30 operations on transmyocardial laser revascularization (TMLR) from 1999.3 to 1999.12. Methods CABG (Coronary Artery Bypass Graft)+TMLR was performed in 20 cases (group A). TMLR only was performed in 10 cases (group B). In group A, we used median sternotomy and TMLR was followed by CABG (mean vessel graft 2.3, mean tunnels 8.2). In group B, TMLR (mean tunnels 31.7) was by left anteriolateral intercostal incision. Results There had been no death, angina disappeared within one month postoperatively. At 3 months follow up angina recurred in one case (5%) in group A, the ischemic region disappeared in ECT, angina was significntly alleviated in 7 cases(70%) of group B, the ischemic area decreased obviously. Conclusion TMLR can relieve angina and improve quality of life.