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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2002, Number 1

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An Med Asoc Med Hosp ABC 2002; 47 (1)

Post-operatory evolution of transmyocardial laser-beam revascularization as only therapy or combined with hemoductal revascularization coronary artery bypass graft surgery

Gloss G, Márquez M, López ME, Fiscal LO, Solís SE, Fernández RG, Barragán GR

Language: Spanish
References: 21
Page: 6-11
PDF size: 47.16 Kb.


ABSTRACT

Transmyocardial laser revascularization is a new therapeutic modality for patients with coronary artery disease who have intractable angina. We studied consecutive patients undergoing transmyocardial laser revascularization in a tertiary referral teaching hospital between February 1997 and September 1998. Eight patients (32%) from a group of twenty-five, developed atrial fibrillation. Six of this patients were submitted to a combination of transmyocardial laser revascularization and coronary artery bypass graft surgery. Three of the patients with atrial fibrillation developed clinical instability who needed electrical cardioversion, and two required orotracheal intubation and mechanical ventilation. Because of this concern, in the following fourteen patients enrolled in this study, we used amiodarone as a prophylaxis against atrial fibrillation in the postoperative period. Only three of the amiodarone treated patients group developed atrial fibrillation. In contrast, of eleven patients initially enrolled in the study and not treated with amiodarone, five (45%) developed atrial fibrillation. In conclusion, atrial fibrillation is not uncommon after transmyocardial laser revascularization when coronary artery bypass grafting surgery is also performed. This study suggests the hypothesis that amiodarone should be prospectively evaluated as prophylaxis against atrial fibrillation in this group of patients.


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