Apr. 22, 1998 Researchers at Temple University Hospital are indicating that the use of heart laser surgery may replace transplantation in certain patients with severe coronary artery disease. Clinical results were reported April 17 at the International Society For Heart and Lung Transplantation Meeting in Chicago, Illinois.
According to Valluvan Jeevanandam, M.D., Surgical Director of the Heart Transplantation Program at Temple University Hospital, "this promising new therapy offers an alternative for patients with severe chest pain who may need a heart transplant." This therapy, termed Transmyocardial Revascularization (TMR), uses a carbon dioxide laser to create upwards of 50 tiny holes in the left ventricle of the heart, which improves blood flow to oxygen-starved heart muscle
. TMR was developed to relieve debilitating chest pain, called angina, in patients who are not candidates for angioplasty or bypass surgery. After six months of follow-up, patients receiving TMR in this study showed a dramatic improvement in the amount of chest pain and quality of life. "We were able to preserve hear function while improving health status without the need for heart transplantation in TMR patients," says Dr. Jeevanandam.
Approximately 250,000 people suffer from end-stage coronary artery disease and that number is growing by an estimated 20% each year. Many of these individuals can not have bypass surgery and are potential heart transplant candidates.
According to Dr. Jeevanandam, "Due to the lack of sufficient numbers of donor hearts, TMR offers a cost-effective alternative to heart transplantation without the side effects of immunosuppression therapy."
Based upon scientific registry data from the United Network for Organ Sharing (UNOS), there are currently about 3,945 patients waiting for a heart transplant.
Using 1996 data, it is estimated that about 20 to 50% of these patients may die while waiting for a donor heart. Dr. Jeevanandam says, "Our survival rate was 85% which compares favorably with survival at 1 year post transplant. We don't know yet if TMR will help these patients live longer, but TMR patients are spared the mortality associated with waiting for a transplant."
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