CURRENT TOPICS IN THE FIELDS OF CARDIOVASCULAR SURGERY

In recent years, laser has been gradually utilized in cardiovascular surgery in response to a background where if any new technologies were not introduced, no further improvement in therapeutic results could be achieved. Since 1980, we have applied lasers experimentally in the following three categories; Group 1: new myocardial revascularization in the patients whose coronary arteries are too small or diffuse due to atherosclerosis; Group 2:laser vascular anastomosis especially for small-caliber vessels; and Group 3: laser angioplasty for obstructive arterial disease. Subsequently, efficacy of laser application could be obviously recognized in these categories. After experimental availavility of laser was confirmed by our basic studies, it was clinically used in 115 patients with anginal pain, intermittent claudication or renal failure up to now. Optimal conditions of vascular anastomosis were 20-40mW in output and 6-12sec/mm in irradiation time. The laser therapy was applied for new myocardial revascularization in one, vascular anastomosis including coronary artery bypass surgery in 91, and angioplasty in 23 cases. Optimal conditions for laser angioplasty were 6 watts in output and 3sec in irradiation time for each shot. Laser irradiation was carefully repeated according to the grade of atherosclerotic changes. These patients are doing well without complications throughout laser. Our clinical experience of laser application in the cardiovascular surgery is presented in detail.