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CO2 HEART LASER System
CO2 HEART LASER System
CO2 HEART LASER for Transmyocardial Revascularization
TransMyocardial Revascularization (TMR) is an effective angina relief therapy for diffusely diseased coronary vessels with poor targets for bypass grafting. During the TMR procedure, small channels are created in the heart tissue in an effort to stimulate improvements in blood flow to regions of the heart. Advanced CO2 technology allows the HEART LASER System to create a channel in a single pulse. The CO2 HEART LASER's channels have been reported to maintain tissue integrity and foster healing. These channels stimulate measurable perfusion, when using TMR to treat areas of the heart that other methods of treatment cannot. The straight and clean channels may lay a foundation for vascular growth and provide long-lasting pain relief. The CO2 HEART LASER's single pulse is synchronized with the heartbeat, firing only when the heart is at rest. This is the point at which the heart is at reduced risk of arrhythmia.
Patients presenting for CABG today are older and sicker than ever before and, therefore, require more complex surgery. Complete revascularization is always the goal in bypass graft surgery, but it is not always attainable. According to the BARI trial, 26% of CABG patients are incompletely revascularized, and according to the ACC/AHA guidelines, angina is prevalent in over 20% of patients two years after CABG. TMR is indicated for revascularization of ischemic myocardium not amenable to direct coronary revascularization. Patients undergoing repeat operation or with diffuse coronary disease and stable angina that present with areas of regional ischemia may benefit from TMR. Data has demonstrated that TMR improves long term angina relief, increases perfusion, and improves patient quality of life.
The CO2 HEART LASER System consists of:
- the CO2 HEART LASER mobile console
- the CO2 HEART LASER disposable hand pieces
Image-guided surgical revascularization provides a greater opportunity for a more complete revascularization. In 2006, the International Society of Minimally Invasive Cardiac Surgeons issued a consensus statement regarding the evidence of balance between the benefit and risks of TMR relative to maximum medical therapy. The American College of Cardiology and American Heart Asssociation have also issued guidelines for TMR stating that transmyocardial surgical laser revascularization either alone or in combination with CABG surgery is reasonable in patients with angina refractory to medical therapy who are not candidates for Percutaneous Coronary Intervention or surgical revascularization.
SPY imaging may be utilized in conjunction with theTMR procedure to enable cardiac surgeons to more effectively locate and document regions of the micro-vascular myocardium that are not being adequately perfused by direct coronary bypass and may benefit from TMR.
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