Effects of pulse excimer laser irradiation on the human left ventricular wall.

M Z Chen, F R Chen, J M Mao, J X Guo, D Y Xie, J R Xu
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Abstract

This study was to assess the potential application of excimer lasers in the ablation of myocardium in vitro for the treatment of constant ventricular tachycardia or hypertrophic cardiomyopathy. A fresh human heart and EMG model 103 XeCl pulse excimer laser machine were used. The pulse repetition rate varied from 1 to 7 Hz. Irradiation directly on the left endocardial and epicardial walls lasted for 10 seconds and was repeated 3 times, creating 3 craters. The histological changes were examined by light microscope. Results showed very close relations between the depth or volume of vaporized craters and the pulse repetition rate on the endocardial (r = 0.9674, P less than 0.001 and r = 0.8962, P less than 0.01, respectively) and epicardial walls (r = 0.9602, P less than 0.001 and r = 0.9612, P less than 0.001, respectively). A sharp, clear border without debris or coagulating necrosis was seen under the microscope. We concluded that the pulse excimer laser, differing from Ar+ or Nd:YAG lasers, might be a powerful tool for manipulating the human ventricular wall, but more work needs to be done before it can be widely applied in the treatment of cardiovascular disease.

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脉冲准分子激光照射对人左室壁的影响。
本研究旨在评估准分子激光在体外心肌消融治疗持续性室性心动过速或肥厚性心肌病中的潜在应用。实验采用新鲜人心脏和103 XeCl型脉冲准分子激光。脉冲重复频率从1到7赫兹不等。直接照射左心内膜和心外膜壁,持续10秒,重复3次,形成3个孔。光镜下观察组织学变化。结果表明,心内膜(r = 0.9674, P < 0.001)和心外膜壁(r = 0.9602, P < 0.001)的脉冲重复率与汽化坑的深度或体积有密切关系(r = 0.8962, P < 0.01)。显微镜下可见清晰的边缘,无碎片或凝固性坏死。我们得出结论,脉冲准分子激光,不同于Ar+或Nd:YAG激光,可能是操纵人类心室壁的有力工具,但在广泛应用于心血管疾病的治疗之前,还需要做更多的工作。
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