Emory Cardiothoracic Surgeons Use New CO2 Laser Technology To Relieve
Symptoms of Severe Coronary Artery Disease
ATLANTA Despite receiving a variety of treatments for coronary artery
disease -- ranging from coronary artery bypass surgery (CABG), coronary
artery angioplasty and stents to medications -- many heart patients
continue to suffer from the chest pain known as angina that occurs when
the heart does not receive enough oxygen-rich blood. Cardiothoracic
surgeons at Emory University Hospital (EUH) can now help many people
with severe coronary artery disease who have run out of traditional
options for relieving angina. The procedure, known as Transmyocardial
Laser Revascularization (TMR), uses a new generation of laser technology
-- the CO2 laser.
During the CO2 TMR procedure, EUH cardiothoracic surgeons Joseph Craver,
MD, and Omar Lattouf, MD, create approximately 20 to 30 channels through
the wall of the heart (myocardium) with the CO2 laser in areas that
can't be helped with other means. "Although the mechanism of how TMR
works to reduce angina is not yet known, carefully done studies have
shown it has a positive benefit for patients and improves the quality
of life, resulting in symptomatic improvement and a dramatic reduction
of subsequent hospitalizations for recurrent chest pain," says Dr. Craver.
According to Dr. Craver, the CO2 laser used at EUH has several advantages
over earlier technology used for TMR. "This new laser is faster, safer
and simpler to use. It makes an immediate, discreet full channel without
damaging the adjacent tissue as opposed to the much wider burns produced
by other lasers," he notes. "I've performed the TMR with the CO2 laser
on twenty five patients with excellent results consistent with our expectations."
The procedure is most frequently applied as an adjunct to bypass surgery
in which some areas of the heart receive bypass grafts; TMR is applied
to other areas where blood vessels are no longer present that would
permit standard bypass surgery or angioplasty. "Other patients who are
not candidates for bypass surgery or angioplasty at all because all
the vessels are gone have had stand alone TMR with the CO2 laser with
good results," says Dr. Craver. "Although the mechanism of how this
new technology helps the heart muscle improve is not clear, the clinical
benefit seems to be solid. There is no data at present that this therapy
extends longevity but this may change as our experiences with this technique
extend over a longer period of time."
On September 29th, thirty cardiac surgeons from other cardiac surgical
centers throughout the U.S. will attend a symposium directed by Dr.
Craver at EUH to learn the TMR procedure using the CO2 laser. "They
will learn how to safely and effectively utilize the CO2 laser to enhance
care for this often desperately ill group of patients with advanced,
inoperable coronary artery blockages," he says.
The CO2 TMR system used at EUH, which is manufactured by PLC Systems
Inc. and distributed by Edwards Lifesciences Corporation, achieved a
clinical milestone in September with the announcement of the 10,000th
patient treated using the PLC's CO2 Heart Laser technology.