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News

Surgeons use new CO2 laser technology to relieve symptoms of Severe Coronary Artery Disease

Emory University : 23 September, 2005  (Technical Article)
Despite receiving a variety of treatments for coronary artery disease, ranging from coronary artery bypass surgery, coronary artery angioplasty and stents to medications, many heart patients continue to suffer from the chest pain known as angina that occurs when the heart does not receive enough oxygen-rich blood.
Cardiothoracic surgeons at Emory University Hospital can now help many people with severe coronary artery disease who have run out of traditional options for relieving angina. The procedure, known as Transmyocardial Laser Revascularization, uses a new generation of laser technology, the CO2 laser.

During the CO2 TMR procedure, EUH cardiothoracic surgeons Joseph Craver, MD, and Omar Lattouf, MD, create approximately 20 to 30 channels through the wall of the heart (myocardium) with the CO2 laser in areas that can't be helped with other means. 'Although the mechanism of how TMR works to reduce angina is not yet known, carefully done studies have shown it has a positive benefit for patients and improves the quality of life, resulting in symptomatic improvement and a dramatic reduction of subsequent hospitalizations for recurrent chest pain,' says Dr. Craver.

According to Dr. Craver, the CO2 laser used at EUH has several advantages over earlier technology used for TMR. 'This new laser is faster, safer and simpler to use. It makes an immediate, discreet full channel without damaging the adjacent tissue as opposed to the much wider burns produced by other lasers,' he notes. 'I've performed the TMR with the CO2 laser on twenty five patients with excellent results consistent with our expectations.'

The procedure is most frequently applied as an adjunct to bypass surgery in which some areas of the heart receive bypass grafts; TMR is applied to other areas where blood vessels are no longer present that would permit standard bypass surgery or angioplasty. 'Other patients who are not candidates for bypass surgery or angioplasty at all because all the vessels are gone have had stand alone TMR with the CO2 laser with good results,' says Dr. Craver. 'Although the mechanism of how this new technology helps the heart muscle improve is not clear, the clinical benefit seems to be solid. There is no data at present that this therapy extends longevity but this may change as our experiences with this technique extend over a longer period of time.'

On September 29th, thirty cardiac surgeons from other cardiac surgical centers throughout the U.S. will attend a symposium directed by Dr. Craver at EUH to learn the TMR procedure using the CO2 laser. 'They will learn how to safely and effectively utilize the CO2 laser to enhance care for this often desperately ill group of patients with advanced, inoperable coronary artery blockages,' he says.

The CO2 TMR system used at EUH, which is manufactured by PLC Systems Inc. and distributed by Edwards Lifesciences Corporation, achieved a clinical milestone in September with the announcement of the 10,000th patient treated using the PLC's CO2 Heart Laser technology.
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