Lasers for Ischemic Heart Disease : Update on Alternatives for the Treatment of Diffuse Coronary Artery Disease

With the growing age of the population, the proportion of elderly patients with diffuse coronary artery disease and severe comorbidities is increasing. The characteristics of these patients render them unsuitable for currently recognized revascularization procedures (CABG, PTCA). Therefore, there is an urgent need for new treatment modalities which could alleviate their symptoms and increase blood flow to the ischemic myocardium, while being less invasive for their fragile condition. The aim of this book is to provide an anatomical and physiological background as well as a complete review of the alternative methods of revascularization which are under development, namely transmyocardial laser revascularization, therapeutic angiogenesis and neurostimulation. Front Matter....Pages I-XV Introduction....Pages 1-1 Historical Background....Pages 2-7 Microvascular Anatomy of the Heart....Pages 8-18 The Vineberg Procedure: A Forgotten Operation?....Pages 19-33 Myocardial Acupuncture: The Immediate Forerunner of Transmyocardial Laser Revascularization....Pages 34-40 Laser Physics....Pages 41-54 Laser Interaction with Tissue....Pages 55-67 Transmyocardial Laser Revascularization: Patient Selection, Operative Technique, and Perioperative Care....Pages 68-73 The Pioneering Era of Transmyocardial Laser Revascularization....Pages 74-76 Laser Channel Morphology....Pages 77-95 Pathophysiology of Transmyocardial Laser Revascularization....Pages 96-132 Clinical Results of Transmyocardial Laser Revascularization....Pages 133-150 Transmyocardial Laser Revascularization and Left Ventricular Function....Pages 151-162 Adverse Effects of Transmyocardial Laser Revascularization....Pages 163-174 Alternative Forms of Transmyocardial Laser Revascularization....Pages 175-178 Angiogenesis: Pathophysiology....Pages 179-189 Therapeutic Angiogenesis: The Basis....Pages 190-195 Therapeutic Angiogenesis: Results....Pages 196-205 Combined Therapy: Transmyocardial Laser Revascularization and Therapeutic Angiogenesis....Pages 206-209 Neurostimulation....Pages 210-215 Back Matter....Pages 216-243