The prevalence of refractory angina (RFA) in the United States is estimated between 600 000 and 1.8 million. With the advances made in the management of coronary artery disease, prolonged survival, and an aging population, the incidence of debilitating angina refractory to medical therapy (also referred to as no-option angina) is increasing. These patients present a major clinical problem becau...

BACKGROUND A mechanism underlying the benefits of transmyocardial laser revascularization (TMLR) has been presumed to be improvement in perfusion. We evaluated myocardial blood flow around a laser channel using digital radiography combined with a 3H-labeled desmethylimipramine ([3H]DMI) deposition. METHODS AND RESULTS A laser channel was created in the left ventricular wall using a YAG-laser ...

My fellow authors and I appreciate the comments expressed in Dr. Horvath’s letter, which largely claim that the sole reason for the negative results demonstrated in our study (1) relates to procedural differences between surgical versus percutaneous transmyocardial laser revascularization (TMR). Although we acknowledged in our study that full-thickness transmyocardial laser channels at surgery ...

There is evidence of angiogenesis being induced after transmyocardial laser revascularization (TMLR), although the precise mechanism has not been fully elucidated. This study was designed to examine whether or not blood flow from the left ventricle through the channels is essential for angiogenesis following TMLR. Ten dogs underwent the creation of two types of laser channels in the left ventri...

INTRODUCTION Randomized and nonrandomized clinical trials have tried to assess whether or not TMR patients experience an increase in myocardial perfusion. However there have been inconsistencies reported in the literature due to the use of different nuclear imaging modalities to test this metric. The primary purpose of this meta-analysis was to determine whether SPECT, MUGA and PET scans demons...

BACKGROUND We investigated the effect of transmyocardial laser revascularization (TMR) on myocardial function and regional blood flow in an animal model of ischemic heart disease. METHODS Chronic ischemia was induced in 11 sheep by the application of coronary stenosis on the left anterior descending (LAD) and circumflex coronary artery (LCX). Ten weeks later, in six of them, transmyocardial c...

Selective laser melting (SLM) is widely used in making three-dimensional functional parts layer by layer. Temperature magnitude and history during SLM directly determine the molten pool dimensions and surface integrity. However, due to the transient nature and small size of the molten pool, the temperature gradient and the molten pool size are very challenging to measure and control. A 3-dimens...