TRANSMYOCARDIAL LASER REVASCULARIZATION IN ALLOGRAFT CORONARY-ARTERY DISEASE

We used transmyocardial laser revascularization to treat accelerated c ardiac allograft atherosclerosis in 2 patients. One patient received t ransmyocardial laser revascularization as sole therapy, the other as a n adjunct to coronary artery bypass grafting. The systolic function im proved in both patients, although the patient who had adjunctive trans myocardial laser revascularization died of systemic infection and rena l failure on postoperative day 55. The second patient is alive and wel l 1 1/2 years after the laser procedure. We discuss 4 other patients w ho received transmyocardial laser revascularization treatment elsewher e in the United States. Transmyocardial laser revascularization has th e potential to become important in the treatment of transplant atheros clerosis. Randomized clinical trials are warranted to assess the effic acy of transmyocardial laser revascularization in this setting. (C) 19 98 by The Society of Thoracic Surgeons.