Titre
La revascularisation transmyocardique au laser--un risque potentiel en condition aiguë [Laser transmyocardial revascularization--a potential risk in an acute situation?]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera
Auteur(s)
Mueller, X.M.
Auteure/Auteur
Tevaearai, H.
Auteure/Auteur
Genton, C.Y.
Auteure/Auteur
Bettex, D.
Auteure/Auteur
von Segesser, L.K.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1023-9332
Statut éditorial
Publié
Date de publication
2000
Volume
6
Numéro
2
Première page
65
Dernière page/numéro d’article
8
Langue
français
Notes
Publication types: English Abstract ; Journal Article - Publication Status: ppublish
Résumé
Morphological and functional effects of transmyocardial laser revascularization (TMLR) are analyzed in an acute setting on a porcine model. Ten channels were drilled in the left lateral wall of the heart of 15 pigs (mean weight, 73 +/- 4 kg) with a Holmium-YAG laser (wavelength: 2.1 mu, probe diameter: 1.75 mm). Echocardiographic control was performed before the TMLR procedure as well as 5 min and 30 min thereafter. Echocardiographic parameters were recorded in short-axis at the level of the laser channels, and included left ventricular ejection fraction, fractional shortening and segmental wall motility of the channels' area (scale 0-3: 0 = normal, 1 = hypokinesia, 2 = akinesia, 3 = dyskinesia). After sacrifice the lased region was sliced perpendicularly to the channels for histological and morphometrical analysis. Five minutes after the drilling of the channels, all the echocardiographic index worsened significantly in comparison with baseline values (p < 0.01). All recovered after 30 min and showed no difference with baseline values. Cross-section of the channel lesions measured 8.8 +/- 2.4 mm2 which is more than three times that of the probe (p < 0.01). In acute conditions, the lesions due to the TMLR probe are significantly larger than the probe itself and cause a transient drop of the segmental wall motility on a healthy myocardium. These results suggest that TMLR should be used cautiously in the clinical setting for patients with an impaired ventricular function.
PID Serval
serval:BIB_4BFFCE8B7A5D
PMID
Date de création
2008-02-14T13:17:42.005Z
Date de création dans IRIS
2025-05-20T15:03:51Z