Sustained angina relief 5 years after transmyocardial laser revascularization with a CO2 laser

K. A. Horvath, S. F. Aranki, L. H. Cohn, R. J. March, O. H. Frazier, K. A. Kadipasaoglu, S. W. Boyce, B. W. Lytle, K. P. Landolfo, J. E. Lowe, B. Hattler, B. P. Griffith, A. M. Lansing

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Background - Although transmyocardial laser revascularization (TMR) has provided symptomatic relief of angina over the short term, the long-term efficacy of the procedure is unknown. Angina symptoms as assessed independently by angina class and the Seattle Angina Questionnaire (SAQ) were prospectively collected up to 7 years after TMR. Methods - Seventy-eight patients with severe angina not amenable to conventional revascularization were treated with a CO2 laser. Their mean age was 61±10 years at the time of treatment. Preoperatively, 66% had unstable angina, 73% had had ≥1 myocardial infarction, 93% had undergone ≥1 CABG, 42% had ≥ PTCA, 76% were in angina class IV, and 24% were in angina class III. Their average pre-TMR angina class was 3.7±0.4. Results - After an average of 5 years (and up to 7 years) of follow-up, the average angina class was significantly improved to 1.6±1 (P=0.0001). This was unchanged from the 1.5±1 average angina class at 1 year postoperatively (P=NS). There was a marked redistribution according to angina class, with 81% of the patients in class II or better, and 17% of the patients had no angina 5 years after TMR. A decrease of ≥2 angina classes was considered significant, and by this criterion, 68% of the patients had successful long-term angina relief. The angina class results were further confirmed with the SAQ; 5-year SAQ scores revealed an average improvement of 170% over the baseline results. Conclusions - The long-term efficacy of TMR persists for ≥5 years. TMR with CO2 laser as sole therapy for severe disabling angina provides significant long-term angina relief.

Original languageEnglish (US)
Pages (from-to)i81-i84
Issue numberSUPPL. 1
StatePublished - Sep 18 2001


  • Angina
  • Coronary disease
  • Laser
  • Revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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