La revascularización transmiocárdica con láser; una vieja técnica. Pero, ¿es efectiva? Estudio retrospectivo sobre una cohorte de 453 pacientes.

  1. Llana Ducrós, Ramiro Javier de la
  2. Ávalos, R.
  3. Gutiérrez, P.
  4. Nassar, M. Ibrahim
  5. Garrido, P.
  6. Abdul-Jalbar Betancor, Beatriz
  7. Martínez, R.
Journal:
Revista española de investigaciones quirúrgicas

ISSN: 1139-8264

Year of publication: 2012

Volume: 15

Issue: 2

Pages: 55-63

Type: Article

More publications in: Revista española de investigaciones quirúrgicas

Abstract

Even after the application of higienical measures, ischemic cardiopathy is still a highly prevalent disease in our environment. After treating those patients medically, surgically and/or percutanously there will be a cohort of cases with difficult medical control and with no more possibilities. To treat those patients, an old technique, described at the beginning of the sixties of last century, and inspired in the heart of reptilians, has been recalled. This technique, called Transmyocardial Revascularization with Laser (TMRL), consists in piercing the whole myocardium with a laser beam. But the results are controversial. To discover the usefulness of this technique, a retrospective study on 453 operated on among may 1999 and november 2004 was performed. Three groups were considered: Group I (53 patients) formed by those patients not able to revascularize totally and complemented by TMRL in the areas not bypassed. Group II (269 pts) in which every patient could be completely revascularized. Group III (130 pts) in which those patients not able to be completely revascularized were just left without any more techniques. The follow-up indicated that the need of medication was not different among groups and the mortality in-hospital as well as in the follow-up, was similar in every group. The patients in group I were, in the long run, in a better functional class than in the other groups. So for we conclude that TMRL associated to surgical coronary by-pass does not implies better results but do not causes higher risks neither at the operation nor in the follow-up.