Coronary artery bypass grafting with concurrent transmyocardial laser revascularization

An increasing number of patients suffer from chronic and unremitting angina pectoris that severely impacts their quality of life. The use of traditional techniques, such as coronary artery bypass graft surgery, may not provide complete revascularization in up to 25% of patients due to the severe and diffuse nature of coronary artery disease. Transmyocardial laser revascularization has emerged as a feasible surgical modality for patients with refractory angina pectoris who have exhausted standard medical and interventional options. Based on the cumulative clinical evidence, transmyocardial laser revascularization plus coronary artery bypass grafting has been shown to provide significant symptomatic relief against angina and improve overall outcomes. As a result, the use of adjunctive transmyocardial laser revascularization with coronary artery bypass grafting is warranted in select patients not amenable to complete myocardial revascularization with conventional interventions.