Improved overall success and repeat revascularization rates may be due to better perfusion of ischemic areas not amenable to bypass. In conclusion, CABG+TMLR appears safe and poses no additional threat for high-risk patients. ![]() The 4-year event-free survival rate was 14% versus 39%, respectively ( P < 0.064). The incidence of repeat revascularization was 24% after CABG alone versus none after CABG+ TMLR ( P < 0.05). Both groups had substantially improved angina and functional status at 1 and 4 years, with no significant differences in cumulative 4-year mortality. The follow-up period was 50.3 ± 17.8 months for CABG alone and 48.1 ± 16.8 months for CABG+TMLR. There were no significant intergroup differences in the number of intraoperative or in-hospital adverse events. Patients undergoing CABG+ TMLR received 25 ± 11 laser channels. The CABG technique, number of grafts, and target vessels were similar in both groups. Preoperatively, 20 patients (47%) were at high risk. ![]() Success was characterized by relief of angina and freedom from repeat revascularization and death. ![]() Clinical status was evaluated at hospital discharge, 1 year, and 4 years. Operative and in-hospital mortality and morbidity rates were monitored. We evaluated transmyocardial laser revascularization (TMLR) with coronary artery bypass grafting (CABG) versus CABG alone for severe coronary artery disease involving ≥1 myocardial region unsuited for CABG.Īt 4 centers, 44 consecutive patients were randomized for CABG+TMLR (n = 23) or CABG alone (n = 21).
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