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Influence of transmyocardial laser revascularizationon anginal symptoms and clinical effect in patientswith incomplete surgical revascularization

Authors: A.V. Krnchoyan1, S.A. Lyashenko2, A.G. Starovoytenko2, A.V. Dyuzhikova2, A.V. Poddubnyy2, A.A. Dyuzhikov1

Company: 1Rostov State Medical University, Nakhichevanskiy pereulok, 29, Rostov-on-Don, 344022, Russian Federation;
2Rostov Regional Clinical Hospital, ulitsa Blagodatnaya, 170, Rostov-on-Don, 344011, Russian Federation

Type:  Original Research


DOI: https://doi.org/10.24022/0236-2791-2018-60-4-325-330

For citation: Krnchoyan A.V., Lyashenko S.A., Starovoytenko A.G., Dyuzhikova A.V., Poddubnyy A.V., Dyuzhikov A.A. Influence of transmyocardial laser revascularization on angina symptoms and clinical effect in patients with incomplete surgical revascularization. Russian Journal of Thoracic and Cardiovascular Surgery. 2018; 60 (4): 325–30 (in Russ.). DOI: 10.24022/0236-2791-2018-60-4-325-330

Received / Accepted:  25.12.2017/06.02.2018

Keywords: coronary artery bypass grafting transmyocardial laser revascularization coronary heart disease

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Abstract

Objective. To evaluate in the long-term period the effect of transmyocardial laser revascularization (TMLR) on anginal symptoms and clinical results in patients who can not be treated with complete revascularization by coronary artery bypass grafting (CABG).

Material and methods. The retrospective study included 106 patients with diffuse atherosclerosis of the coronary arteries who underwent CABG with incomplete revascularization in 2007–2013. In 60 patients (the median age 65.9±7.3 years) CABG+TMLR was perfomed (Group 1), and in 46 patients (the median age 60.8±7.9 years) only CABG was conducted (Group 2). The initial parameters assessed in clinical practice were not significantly different in these groups. The follow-up (mean 7.5±0.9 years) included the evaluation of survival rate and return of angina.

Results. Long-term mortality during the follow-up period in Group 1 was 7.6% (n=4), and in Group 2 – 18.9% (n=7). In both groups, the functional class of angina pectoris significantly decreased, but in Group 1 this tendency was more expressed: 54 (90%) patients had Class 1 exertional angina vs. 33 (71.7%) in Group 2, p=0.02.

Conclusion. The analysis of the results of 7-year follow-up in patients with diffuse lesions of the coronary arteries proves that TMLR
in combination with CABG helps to improve the efficacy of incomplete revascularization.

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About Authors

  • Artashes V. Krnchoyan, Postgraduate, orcid.org/0000-0002-5978-7632;
  • Sergey A. Lyashenko, Cardiologist;
  • Aleksey G. Starovoytenko, Cardiac Surgeon;
  • Anastasiya V. Dyuzhikova, Cand. Med. Sc., Ultrasound Diagnostician, orcid.org/0000-0002-3966-386X
  • Andrey V. Poddubnyy, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-5053-6888;
  • Aleksandr A. Dyuzhikov, Dr. Med. Sc., Professor, Director of the Cardiac Surgery Center

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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