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Abstract
Despite the success of current medical and surgical management of ischemic heart disease, a growing number of patients have diffuse obstructive coronary artery disease that is not amenable to coronary-artery bypass grafting or catheter-based interventions it is estimated that patients with ungraftable coronary artery disease account for approximately 5% of patients who undergo coronary angiography. The failure to revascularize even a single ischemic coronary artery due to poor graftability is associated with a decrease in both survival and freedom from angina in these patients, regardless of the presence of a patent left internal thoracic artery bypass to the left anterior descending artery.
In 1983, Mirhoseini et al used TMLR on a patient with coronary artery disease. They used a carbon dioxide laser in conjunction with CABG to treat a hypokinetic area of the left ventricle. The patient did well, with normal ventricular function demonstrated during a postoperative nuclear scan. These initial clinical studies provided further impetus for the use of TMLR. Since the early 1990s, carbon dioxide laser systems have been used to perform TMLR in humans, with excellent results.
The aim of this work is to evaluate the results of TMLR in patient with coronary artery disease, in whom PCI or CABG cannot be done.
To study the functional status outcome of these patients in early post-operative period and observe the occurrence of any complications.