MORPHOLOGICAL RESULTS OF TRANSMYOCARDIAL REVASCULARIZATION WITH THE USE OF SEMICONDUCTOR LASERS WITH A WAVELENGTH IN THE INFRARED RANGE OF 1.56 AND 1.94 µm IN THE EXPERIMENT
Introduction. Transmyocardial laser revascularization (TMLR) showed good results in the treatment of patients with coronary artery disease. Different types of lasers are used at TMLR, including semiconductor laser with a wavelength of 1,56 µm. "IRE-Polus 1,94" laser (Russia) is designed to improve performance in areas of neoangiogenesis penetration. Material and methods. The work was done based on operations on 15 healthy mongrel dogs. The study consisted of two groups: the first study group included TMLR procedures performed with a "IRE-Polus 1,56" laser, the second group included TMLR procedures performed with "IRE-Polus 1,94" laser. During each operation TMLR procedures were performed with use of 2 types of lasers in 2 different areas of the front wall of the left ventricle with the use of one fiberglass fiber (diameter 0.6 mm) at the same continuous wave mode and at the same power (10 Watts) lasers, as well as using thoracoscopic techniques. Comparing the effectiveness of two types of lasers at TMLR was performed according to the morphological studies based on the degree of neoangiogenesis in areas of TMLR channels. Neoangiogenesis degree was determined by the density ratio of the new microvasculature channel, which was calculated as the ratio of the number of new vessels to the area of TMLR channel cross section, in 7 days, 3 and 6 monts. Results. Minimally invasive TMLR procedures were implemented fully effectively and safely. According to the morphological study it was noted that in first and second study groups 7 days after surgery, TMLR channels were thrombosed, a new microcirculatory bed was formed in their area. With the statistically true p <0,05 (Wilcoxon) more in 3 months compared to 7 days after the operation, and these values remain unchanged within 6 months after surgery. Biggest coefficient statistically true p <0,05 (U-test Mann-Whitney) more in second study group in comparison with first study group. Conclusion. Thoracoscopic TMLR with the used of semiconductor lasers is an effective and safe procedure. According to morphological studies in the areas of TMLR channels created with the "IRE-Polus 1,56" and "IRE-Polus 1,94" lasers, a new microcirculatory bed is formed, while coefficient in second study group is higher than in the first study group.