Transmyocardial revascularization: The fate of myocardial channels

Attempted cardiac revascularization through laser-made channels has gained considerable recent notoriety. Although the treatment reduces angina, its a bility to enhance perfusion is unclear, and the mechanism of action unknown . The fate of the channels appears an obvious place to look for insight. Th erefore, this review focuses on temporal and spatial changes in channel mor phology. An appreciation of the natural history of the channels not only ha s potential to elucidate mechanisms, but also to provide the basis for opti mization of channel-making. (C) 1999 by The Society of Thoracic Surgeons.