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European Heart Journal 1999 20(1):31-37; doi:10.1053/euhj.1998.1202
Copyright © 1999 by the European Society of Cardiology.
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The transmyocardial laser revascularization international registry report

S.M. Burnsa,f1, L.D. Sharplesb, S. Taita, N. Cainea, J. Wallworka and P.M. Schofielda

a Departments of Cardiology and Cardiothoracic Surgery and Research and Development Unit, Papworth Hospital NHS Trust, Papworth Everard, Cambridge, U.K.
b MRC Biostatistics Unit, Institute of Public Health, Cambridge, U.K.

accepted June 10, 1998

Abstract

Aims

This report aimed to provide an analysis of the data submitted from Europe and Asia on transmyocardial laser revascularization.

Methods and Results

Prospective data was recorded on 967 patients with intractable angina not amenable to conventional revascularization in 21 European and Asian centres performing transmyocardial laser revascularization using the PLC Medical Systems CO2laser. Patient characteristics, operative details and early complications following transmyocardial laser revascularization were recorded. The in-hospital death rate was 9·7% (95% confidence interval 7·8% to 11·6%). Other early complications were consistent with similar cardiothoracic surgical procedures. There was a decrease of two or more Canadian Cardiovascular Score angina classes in 47·3%, 45·4% and 34·0% of survivors at 3, 6 and 12 months follow-up, respectively (P=0·001 for each). Treadmill exercise time increased by 42s at 3 months (P=0·008), 1min 43s at 6 months (P<0·001) and 1min 50s at 12 months (P<0·001) against pre-operative times of 6min.

Conclusion

Uncontrolled registry data suggest that transmyocardial laser revascularization may lead to a decrease in angina and improved exercise tolerance. It does, however, have a risk of peri-operative morbidity and mortality. Definitive results from randomized controlled trials are awaited.

Key Words: Transmyocardial laser revascularization, Transmyocardial Laser Revascularization Registry

f1 Correspondence: Dr S. M. Burns, Department of Cardiology, Papworth Hospital NHS Trust, Papworth Everard, Cambridge CB3 8RE, U.K.

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