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Quantification of microembolic signals during transmyocardial laser revascularization

^a Clinic of Cardiac Surgery, University Clinic of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
^b Clinic of Neurology, University Clinic of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
^c Department of Neurology, University of Giessen, Giessen, Germany

^* Corresponding author. Tel.: +49-451-500-2108; fax: +49-451-500-2051
sievers{at}medinf.mu-luebeck.de

Transmyocardial laser revascularization (TMLR) is known to induce cerebral microembolic signals (MES). We quantified laser induced MES in patients undergoing TMLR during cardiopulmonary bypass for coronary artery bypass grafting (group A) and during TMLR treatment alone (group B). The total number of MES during a single laser application with identical energy was significantly higher in group A compared to group B (). Also the peak of MES occurred significantly later in group A (). An increase of laser energy was associated with an increase in numbers of MES particular in group B (). Different TMLR modalities generate different amounts of cerebral microembolic signals. Thus, adjustment of TMLR to these modalities may reduce potentially harmful cerebral microemboli and warrants further evaluation.

Key Words: Transcranial Doppler; Transmyocardial laser revascularization; Microembolic signals