Two new strategies of direct myocardial revascularization are based, respectively, on the use of laser energy to create transmyocardial channels that perfuse the heart, transmyocardial revascularization, and the administration of growth factors to stimulate new blood vessel growth (therapeutic angiogenesis). Although these therapies appear to represent markedly different treatment strategies, they may be very similar. Transmyocardial revascularization utilizes laser energy in an attempt to create channels in the myocardium that can direct oxygenated blood from the left ventricular cavity into the ischemic myocardium, bypassing the coronary vasculature altogether. Therapeutic angiogenesis describes the strategy of administering growth factors via a variety of delivery techniques in order to enhance myocardial revascularization. A great deal of controversy exists as to whether transmyocardial revascularization actually induces the formation of patent channels or whether the injury induced by transmyocardial revascularization causes an increase in endogenous growth factors, known to be a natural response mechanism to injury, and thereby induces angiogenesis, much like the exogenous delivery strategies.
|Number of pages||7|
|Journal||Cardiovascular Reviews and Reports|
|Publication status||Published - 1 Dec 2000|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine