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Direct Myocardial Revascularization: History, Methodology, Technology (Hardcover, 1999 ed.)
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Direct Myocardial Revascularization: History, Methodology, Technology (Hardcover, 1999 ed.)
Series: Developments in Cardiovascular Medicine, 211
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The last five years have witnessed an increasing interest in the
subject of transmyocardial laser revascularization (TMR) as
illustrated by the number of abstracts presented at the meetings of
the American Heart Association and the American College of
Cardiology (Figure). The ideas and concepts associated with this
particular method of myocardial revascularization have changed
dramatically over even this short period of time. The original
premise of "de-evolving" mammalian hearts to recreate a
reptilian-like myocardial circulation by making multiple channels
through the myocardium has been almost (but perhaps not quite)
completely dismissed. Now, the most popular notion is that there is
an angiogenic response to myocardial channel making. It is this
development of new blood vessels that is thought to be responsible
for the apparent improvements in symptoms and blood flow. Along the
way, the idea that a channel could stay open and allow blood to
flow directly from the ventricular chamber has found little
support. Rather than directly explore all of these issues and
merely duplicate previously published articles, our aim was to take
a novel approach: that is, to step back from these arguments and
provide perspective from the vantage point of distance. In the case
of trans myocardial revascularization, distance comes both in terms
of history and in terms of methodology and knowledge from other
fields of research. Historically, innovative methods of myocardial
revascularization are by no means uncommon. The first two chapters
deal with this historical' perspective.
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