高龄高危患者激光心肌血运重建术

采用美国PLC产CO2 激光心脏打孔器 ,对 33例高龄 ( 68～ 78岁 )冠心病心绞痛患者在食管超声心动图(TEE)监测下行心肌打孔 平均打孔 ( 2 2± 5)个 ]。结果 :无手术死亡 ,术后 4 8h内因急性心肌梗死死亡 2例 ,因心源性休克 (原因不明 )死亡 1例 ;少数患者发生心律失常、精神症状、自发性气胸等并发症。 2 6例患者术后随访 1～ 36月 ,其中 2 3例 ( 88% )患者心绞痛改善或消失 ;1 6例 ( 62 % )单光子发射型计算机断层显示心肌灌注有不同程度改善。提示 :应用高功率CO2 激光对高龄高危冠心病患者行激光打孔心肌血运重建术安全、有效 ;并应加强围术期管理

Transmyocardial Laser Revascularization in Senile Patients with High Risk

To report the perioperative characteristics in transmyocardial laser revascularization (TMLR) in senile patients .TMLR was performed on the beating heart with high power CO₂ laser (the Heart Laser, ^TMPLC. Inc.)in 33 high risk cases. Transesophageal echocardiography (TEE) showed the average number of channels was 22±5. The follow up ranged from 1 to 24 months was made to assess angina class and myocardial perfusion. 2 patients died of acute myocardial infarction and one died of cardiac shock. Some people suffered related complications such as arrhythmia, pneumothorace, etal. The follow-up included 26 patients. The angina status were improved in 23(88%) patients. ²⁰¹Tl-SPECT showed a remarkable improvement in reversible ischemia in 16(62%) follow up patients. TMLR for patients with high risk is safe and effective. Monitor during operation is very important for prognosis.