The transmyocardial laser revascularization international registry report

Aims This report aimed to provide an analysis of the data submitted from Eu rope and Asia on transmyocardial laser revascularization. Methods and Results Prospective data was recorded on 967 patients with intr actable angina not amenable to conventional revascularization in 21 Europea n and Asian centres performing transmyocardial laser revascularization usin g the PLC Medical Systems CO2 laser. Patient characteristics, operative det ails and early complications following transmyocardial laser revascularizat ion were recorded. The in-hospital death rate was 9.7% (95% confidence inte rval 7.8% to 11.6%). Other early complications were consistent with similar cardiothoracic surgical procedures. There was a decrease of two or more Ca nadian Cardiovascular Score angina classes in 47.3%, 45.4%, and 34.0% of su rvivors at 3, 6 and 12 months follow-up, respectively (P=0.001 for each). T readmill exercise time increased by 42 s at 3 months (P=0.008), 1 min 43 s at 6 months (P<0.001) and 1 min 50 s at 12 months (P<0.001) against pre-ope rative times of 15 min. Conclusion Uncontrolled registry data suggest that transmyocardial laser re vascularization may lead to a decrease in angina and improved exercise tole rance. It does, however, have a risk of peri-operative morbidity and mortal ity. Definitive results from randomized controlled trials are awaited.