Changes in myocardial perfusion after transmyocardial laser revascularization in patients with end-stage angina pectoris

The purpose of the present study was to analyze the effects of transmyocard ial laser revascularization (TMLR) on myocardial perfusion. The value of Tc -99m-MIBI scintigraphy in the detection of changes in perfusion of the lase d and nonlased segments was assessed as well. In 15 patients before TMLR an d then 3 and 6 months afterwards, MIBI scintigraphy and a stress test were carried out. At the beginning of the study, all patients were classified as having angina pectoris class III or IV (according to the criteria of the C anadian Cardiac Society); their ejection fraction was > 30 %. The parameter s of the stress test increased significantly in 70% of the patients. Cardia c scintigraphy revealed improved perfusion of 33.7% of the transient defect s within 3 months after TMLR which persisted at 6 months with a clear trend towards further improvement in the lased segments. TMLR has been found to be particularly beneficial in patients in whom other invasive methods of tr eatment cannot be applied. Copyright (C) 2001 S. Karger AG, Basel.