Lasers in Cardiovascular Medicine and Surgery: Fundamentals and Techniques PDF
Preview Lasers in Cardiovascular Medicine and Surgery: Fundamentals and Techniques
LASERS IN CARDIOVASCULAR MEDICINE AND SURGERY: FUNDAMENTALS AND TECHNIQUES Developments tn Cardiovascular Medicine Reiber, J .H.C., Serruys, P. W., Slager, C.].: Quantitative coronary and left ventricular cineangiography. ISBN 0-89838-760-4. DICM 51 Fagard, R.H., Beksert, I.E., eds.: Sports cardiology. ISBN 0-89838-782-5. DICM 52 Reiber,J.H.C., Serruys, P.W., eds.: State of the art in quancitative coronary arteriography. ISBNO-89838-804-X. DICM 53 Roelandt, J., ed.: Color doppler flow imaging. ISBN 0-89838-806-6. DICM 54 van der Wall. E.E., ed.: Noninvasive imaging of cardiac metabolism. ISBN 0-89838-812-0. DICM 55 Liebman, J., Plonsey, R., Rudy, Y., eds.: Pediatric and fundamental electrocardiography. ISBN 0-89838-815-5. DICM 56 Higler, H., Hombach, V., eds.: Invasive cardiovascular therapy. ISBN 0-89838-818-X. DICM 57 Serruys, P. W., Meester, G. T., eds.: Coronary angioplasty: a controlled model for ischemia. ISBN 0-89838-819-8. DIeM 58 Tooke, J .E., Smaje, L.H., eds.: Clinical investigation of the microcirculation. ISBN 0-89838-833-3. DICM 59 van Dam, Th., van Oosterom, A., eds.: Electrocardiographic body surface mapping. ISBN 0-89838-834-1. DICM 60 Spencer, M.P., ed.: Ultrasonic diagnosis of cerebrovascular disease. ISBN 0-89838-836-8. DICM 61 Legaro, M.]., ed.: The stressed heart. ISBN 0-89838-849-X. DICM 62 Safar, M.E., ed.: Arterial and venous systems in essential hypertension. ISBN 0-89838-857-0. DICM 63 Roelandt, J., ed.: Digital techniques in echocardiography. ISBN 0-89838-861-9. DICM 64 Dhalla, N.S., Singal, P.K., Beamish, R.E., eds.: Pathophysiology of heart disease. ISBN 0-89838-864-3. DICM 65 Dhalla, N.S., Pierce, G.N., Beamish, R.E., eds.: Heart function and metabolism. ISBN 0-89838-865-1. DICM 66 Dhalla, N.S., Innes, I.R., Beamish, R.E., eds.: Myocardial ischemia. ISNB 0-89838-866-X. DICM 67 Beamish, R.E., Panagia, V., Dhalla, N.S., eds.: Pharmacological aspects of heart disease. ISBN 0-89838-867 -8. DICM 68 Ter Keurs, H.E.D.]., Tyberg, J. V., eds.: Mechanics of the circulation. ISBN 0-89838-870-8. DICM 69 Sideman, S., Beyar, R., eds.: Activation metabolism and perfusion of the heart. ISBN 0-89838-871-6. DICM 70 Aliot, E., Lazzara, R., eds.: Ventricular tachycardias. ISBN 0-89838-881-3. DICM 71 Schneeweiss, A., Schettler, G.: Cardiovascular drug therapy in the elderly. ISBN 0-89838-883-X. DICM 72 Chapman, J. V., Sgalambro, A., eds.: Basic concepts in doppler echocardiography. ISBN 0-89838-888-0. DICM 73 Chien, S., Dormandy, J., Ernst. E., Matrai, A., eds.: Clinical hemorheology. ISBN 0-89838-807 -4. DICM 74 Morgantoth, J., Moore, E. Neil, eds.: Congestive heart failure. ISBN 0-89838-955-0. DICM 75 Heintzen, P.H., Bursch, J.H., eds.: Progress in digital angiocardiography. ISBN 0-89838-965-8. DICM 77 Scheinman, M., ed.: Catheter ablation of cardiac arrhythmias. ISBN 0-89838-967 -4. DICM 78 Spaan, J.A.E., Bruschke, A. V.G., Gittenberger, A.C., eds.: Coronary circulation. ISBN 0-89838-978-X. DICM 79 Bayes de Luna, A., ed.: Therapeutics in cardiology. ISBN 0-89838-981-X. DICM 81 Visser, c., Kan, G., Meltzer, R., eds.: Echocardiography in coronary artery disease. ISBN 0-89838-979-8. DIeM 80 Singal, P.K., ed.: Oxygen radicals in the pathophysiology of heart disease. ISBN 0-89838-375-7. DICM 86 Iwata, H., Lombardini, J.B., Segawa, T., eds:: Taurine and the heart. ISBN 0-89838- -. DICM 93 Mirvis, D.M., ed.: Body surface electrocardiographic mapping. ISBN 0-89838-983 -6. DICM 82 Morganroth, J., Moore, E.N., eds.: Silent myocardial ischemia. ISBN 0-89838-380-3. DICM 88 LASERS IN CARDIOV ASCULAR MEDICINE AND SURGERY: FUNDAMENTALS AND TECHNIQUES Edited by George S. Abela, M. D. UNIVERSITY OF FLORIDA GAINESVILLE, FLORIDA Kluwer Academic Publishers BOSTON DORDRECHT LONDON DISTRIBUTORS for North America: Kluwer Academic Publishers 101 Philip Drive Assinippi Park Norwell, Massachusetts 02061 USA fur all other countries: Kluwer Academic Publishers Group Distribution Centre Post Office Box 322 3300 AH Dordrecht, THE NETHERLANDS Library of Congress Cataloging-in-Publication Data Lasers in cardiovascular medicine and surgery: fundamentals and techniques 1 edited by George S. Abela. p. cm.-(Developments in cardiovascular medicine, DICM 103) Includes bibliographical references. ISBN-13: 978-1-4612-8801-5 1. Cardiovascular system-Laser surgery. 2. Laser angioplasty. I. Abela, George S. II. Series: Developments in cardiovascular medicine; v. 103. (DNLM: 1. Cardiovascular Diseases-therapy. 2. Laser Surgery. 3. Lasers-therapeutic use. 4. Vascular Surgery. WI DE997VME v. 1031 WG 170 L3431 DE997VME v. 103/WG 170 L3431 RD598.35.L37L37 1990 617.4' 13059-dc20 DNLM/DLC for Library of Congress 89-19854 CIP Copyright 1990 by Kluwer Academic Publishers Soffcover reprint of the hardcover 1s t edition 1990 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher, Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park, Norwell, Massachusetts 02061. ISBN-I3: 978-1-4612-8801-5 e-ISBN-13: 978-1-4613-1489-9 001: 10.1007/978-1-4613-1489-9 CONTENTS Contributing Authors Vll 8. Light Distribution, Optical Preface Xl Properties, and Cardiovascular Tissues 93 George S. Abela Foreword X111 Martinj.C. van Gernert, AI Welch, Steven L. jacques, Wai-Fung Cheong, and Willem M. Star C. Richard Conti III. EXPERIMENTAL STUDIES: LASER I. HISTORICAL BACKGROUND 1 TISSUE INTERACTION, PROTODYNAMIC THERAPY, 1. The History and Development of the SPECTROSCOPY, ELECTROPHYSIOLOGY 111 Medical Laser 3 Leon Goldman 9. Immediate and Chronic Effects of Laser Angioplasty 113 2. Historical Background, George S. Abela Development, and Future Trends of Lasers in Cardiovascular 10. Photosensitizer-Enhanced Laser Disease 9 Angioplasty 143 George S. Abela G. Michael Vincent, George S. Abela and Enrico Barbieri II. LASER PHYSICS IN MEDICAL 11. Laser-Induced Arterial Fluorescence APPLICATIONS 19 Spectroscopy 153 3. Laser Physics and its Relevance to Lawrence I. Decklebaum Applications in Medicine 21 12. Laser Balloon Angioplasty: jimjohnson Experimental In-Vivo and In-Vitro Studies 167 4. Laser Sources for Angioplasty 31 j. Richard Spears, I. Nigel Sinclair, and Ronald Robert F. Bonner, Paul D. Smith, Louis G. D.jenkins Prevosti, Antonio Bartorelli, Yaron Almagor, and Martin B. Leon 13. Laser Catheter Ablation of 5. The Excimer Laser-Tissue Arrhythmias 189 Interactions and Early Clinical AnneB. Curtis, G. Michael Vincent and George Results 45 S. Abela Frank W. Cross, and Timothy j. Bowker IV. LASER DELIVERY SYSTEMS 201 6. Laser Physics and Thermal Properties 59 14. Optical Fibers 203 AI Welch, Martinj.C. van Gemert, and Stephan E. Friedl, Biqing Ye and George S. Wai-Fung Cheong Abela 7. Thermal Analysis of Laser Ablation of 15. Laser Angioplasty with Optically Cardiovascular Tissue 73 Modified Fiber Tips 209 Massoud Motamedi, Gerald L. LeCarpentier, Cornelius Borst, Rudolf M. Verdaasdonk, and jorgeH. Torres, andAJ. Welch Rienk Rienks v VI CONTENTS 16. Catheter Systems for Laser 25. Laser Endarterectomy 347 Angioplasty 229 john Eugene, Yvon Baribeau, and Michael W. Berns GeorgeS. Abela, andGeraldR. Barbeau 26. Vascular Tissue Bonding Using Laser V. CLINICAL EXPERIENCE WITH LASER ANGIOPLASTY 255 Energy 361 Rodney A. White, George Kopchok, and Geoffrey 17. Clinical Experience with Laser White Angioplasty 257 27. Percutaneous Laser Myoplasty for Gerald R. Barbeau and George S. Abela Treatment of Hypertrophic Cardiomyopathy 373 18. Laser Recanalization and Treatment of Peripheral Atherosclerosis: A Dov Gal, Douglas Losordo, andjeffrey M. Isner Vascular Surgeon's 28. Direct Myocardial Revascularization: Perspective 27 3 Preliminary Experience 385 james M. SeegerandGeorgeS. Abela Mahmood Mirhoseini and Mary M. Cayton 19. Intraoperative Use of the Laser for Coronary Artery Disease 283 VII. ANGIOSCOPY AND ULTRASOUND GUIDANCE 397 james]. Livesay 29. Percutaneous Cardiovascular 20. Laser Thermal Angioplasty with an Angioscopy 399 Argon-Laser-Heated, Metallic- Yasumi Uchida Capped Fiber optic 291 Timothy A. Sanborn 30. Angioscopy of Congenital Cardiac Lesions 411 21. Laser Angioplasty Using a Special Michel Sargin Sapphire-Tip Catheter: Preliminary 31. Intravascular Ultrasound Clinical Trial 301 Imaging 423 j. Louis Fourier, and M. Bertrand john A. Mallery, jonathan M. Tobis, james M. Gessert, james M. Griffith, Michael W. Berns, 22. Laser Angioplasty: New and Walter L. Henry Modalities 307 Herbert j. Geschwind VIII. INDUSTRIAL, REGULATORY AND POPULATION ANALYSIS 437 23. Evaluation, Treatment, and Care of the Laser Angioplasty Patient: A 32. Safety and Effectiveness in Clinical Nursing Perspective 315 Trials Involving Lasers: Food and Drug Administration Sharonjablonski Perspective 439 VI. ADDITIONAL CLINICAL EXPERIENCE Richard P. Felten, and Lynne A. Reamer WITH OTHER CARDIOVASCULAR LASER APPLICATIONS 325 33. Market Trends and Business Considerations 449 24. Laser Modification of the Stephen M. Fry Myocardium for the Treatment of Cardiac Arrhythmias: Background, 34. The Acceptance of Percutaneous Current Results, and Future Transluminal Angioplasty and Laser Possibilities 327 Angioplasty 459 Robert H. Svenson, Laszlo Littmann,john]. john Abele Gallagher, jay Selle, Samuel Zimmern, john Glossary 465 Fedor, Marie-Claire Marroum, Kathleen Seifert, George P. Tatsis, and Kathy Linder Index 469 CONTRIBUTING AUTHORS George S. Abela, M.D. Boulevard du Professor J. Leclercq Associate Professor of Medicine 59037 Lille Cedex Director, Cardiovascular Laser Laboratory France Department of Medicine/Cardiology Robert F. Bonner, Ph.D. University of Florida Physicist Gainesville, FL 32610 National Institutes of Health USA Electrical and Electronic Engineering of John E. Abele, Ph.D. Biomedical Engineering and Instrumentation Branch Co-Chairman Boston Scientific Corporation Division of Research Service 480 Pleasant St. 9000 Rockville Pike Watertown, MA 02172 Bldg. 13, Rm 3W13 USA Bethesda, MD 20892 USA Yaron Almagor, M.D. Research Fellow Cornelius Borst, M.D. Cardiology Branch Professor of Experimental Cardiology Heart, Lung and Blood Instituce Academisch Ziekenhuis Utrecht NIH Cathari j nesingel Building 10 3511 GV Utrecht Bethesda, MD 20892 The Netherlands USA Timothy J. Bowker, MA Gerald R. Barbeau, M.D. Clinical Lecturer Associate Clinical Professor The Cardiothoracic Institute Institute De Cardiologie De Quebec The Brompton Hospital 2725 Chemin Ste-Foy, Sainte-Foy Fulham Road Province de Quebec London Canada United Kingdom Enrico Barbieri, M.E. Mary M. Cayton, R.N. Fulbright Scholar Clinical Specialist Cardiovascular Surgery Institute of Cardiology of the University of Verona Clinical Specialist Laser Surgery Verona, Italy St. Luke's Medical Center Yvon Baribeau, M.D. Heart and Lung Institute of Wisconsin 717 Bay St. Laser Research Laboratory #902 Toronto, Onrario Clement Zablocki Veterans Administration Medical Center M15G2J9, Canada Milwaukee, Wisconsin USA Antonio Bartorelli, M.D. Research Fellow Wai-Fung Cheong, Ph.D. Cardiology Branch Biomedical Engineering Program NHLBI The University of Texas at Austin NIH Austin, TX 78712 Bethesda, MD 20892 USA USA Anne B. Curtis, M.D. Michael W. Berns, M.D. Associate Professor Professor of Surgery Director of Electrophysiology Developmental & Cell Biology BoxJ-277 JHMHC Director, Beckman Laser Institute College of Medicine University of California, Irvine University of Florida 101 The City Drive Gainesville, Florida 32610 Orange, CA 92668 USA USA Frank W. Cross, M.D. Michael E. Bertrand, M.D. Senior Surgical Registrar Professor and Chief 7 Millers Way Service de Cardiologie B et Hemodynamic Horsford H6pital Cardiologique Norwich, Norfolk NR 103 DV Centre Hospitalier Regional et Universitaire de Lille United Kingdom Vll V1l1 CONTRIBUTING AUTHORS Lawrence 1. Decklebaum, M.D. Service D' explorations Fonctionnelles Assistant Professor of Medicine Inserm U 138 Yale University School of Medicine C.H. U. Henri-Modor 51, Ave. Du Marechal De Lattre de Director, Cardiac Catheterization Lab Tassigny West Spring Street 94010 Creteil West Haven, CT 06516 France USA James M. Gessert John Eugene, M.D. Display Systems Engineer Associate Professor of Surgery InterTherapy, Inc. University of California, Irvine Costa Mesa, CA 23451 Madison Street, Ste. 160 USA Torrance, CA 90505 James M. Griffith, Ph.D. USA Director, Research & Development John Fedor, M.D. InterTherapy, Inc Medical Director, Cardiac Rehabilitation Program Costa Mesa, CA Laser and Applied Technologies Laboratory USA Sanger Clinic Leon Goldman, M.D. 1960 Randolph Road Professor Emeritus Charlotte, NC 28232-2861 University of Cincinnati USA Laser Consultant Richard P. Felten Naval Hospital, San Diego Research Chemist 7811 Eads Ave. #304 Food and Drug Administration LaJolla, CA 92037 Center for Devices and Radiological Health USA 12709 Twinbrook Parkway Walter 1. Henry, M.D. Rockville, MD 20857 Professor of Medicine USA Vice Chancellor, Health Sciences and Jean-Louis Fourrier, M.D. Dean, California College of Medicine Chef de Clinique University of California, Irvine Universite de Lille USA Service de Cardiologique de Lille Jeffery Isner, M.D. Boulevard du Professeur J. Leclerccq Professor of Medicine and Pathology 59037 Lille Cedex Tufts University School of Medicine France Chief, Cardiovascular Research Stephan E. Friedl, ME.E. St. Elizabeth's Hospital of Boston Department of Medicine/Cardiology 736 Cambridge Street University of Florida Boston, MA02135 BoxJ-277 JHMHC USA Gainesville, Florida 32610 Sharon Jablonski, RN USA Clinical Research Nurse StephenM. Fry, Ph.D. 500-110 Ave. N., #506 President, Strategic Business Development, Inc. St. Petersburg, FL 33716 P.O. Box 1155 Hanalei USA Kauai, Hawaii 96714 Stephen 1. Jacques, Ph.D. USA Wellman Laboratory of Photom edicine DovGal, D.V.M. Department of Dermatology St. Elizabeth's Hospital of Boston Massachusetts General Hospital Departments of Biomedical Research and Medicine Boston, MA 02114 (Cardiology) USA 736 Cambridge Street Ronald D. Jenkins, M.D. Boston, MA 02135 Fellow, Cardiology Division USA Charles A. Dana Research Institute and JohnJ. Gallagher, M.D. Harvard Thorndike Laboratory of Beth Israel Hospital Director, Electrophysiology Services, Lasers and Applied Department of Medicine Technologies Laboratory Cardiovascular Division Sanger Clinic Beth Israel Hospital 1960 Randolph Road Harvard Medical School Charlotte, NC 28207 Boston, MA 02115 USA USA Herbert 1. Geschwind, M.D. Jim Johnson, Ph.D. Director Cardiac Catheterization Laboratory President, Photon Dynamics Ltd., Inc. CONTRIBUTING AUTHORS IX 4722 Arrow Rd. Cardiac Thoracic Surgery Orlando, FL 32806 Medical College of Wisconsin USA Laser Research Laboratory 2722 W. Oklahoma Ave. George Kopchok, B.S. Milwaukee, Wisconsin 53215 Harbor/UCLA Medical Center USA 1000 W. Carson Street Torrance, CA 90502 USA Massoud Motamedi, Ph.D. Assistant Professor of Internal Medicine GeraldL. LeCarpentier, M.S. Wayne State University Graduate Student Engineering Director of the Cardiac Laser Program University of Texas Louis Elliman Research Building Engineering Science Building, Room 639 421 East Canfield St. Austin, TX 78712 Detroit, Michigan 48201 Martin B. Leon, M.D. USA Senior Investigator and Co-Director of the Cardiac Catheterization Laboratory Louis G. Prevosti, M.D. Cardiology Branch Research Associate National Institutes of Health Heart, Lung and Blood Institute 12900 Lake Ave. Building 10 Room 7315 Suite 526 Bethesda, MD 20892 Lakewood, Ohio 44107 USA Lynne Reamer Kathy Linder, M.S. Division of Cardiovascular Devices Laser and Applied Technologies Laboratory Bureau of Medical Devices Sanger Clinic Food and Drug Administration 1960 Randolph Road 1390 Piccard Dr. Charlotte, NC 28207 Rockville, MD 20850 USA USA Lazlo l.ittmann, M.D. Rienk Rienks, M.D. Director of Electrophysiology Research Academisch Ziekenhuis Utrecht Carolina Heart Institute Heart-Lung Institute Utrecht P.O. Box 32861 Department of Cardiology Charlotte, NC 28232 Room 62.002 USA Catharijnesingel 101 JamesJ. Livesay, M.D. 3511 GV Utrecht Associate in Cardiovascular Surgery The Netherlands Texas Heart Institute and Attending Surgeon Timoth A. Sanborn, M.D. St. Lukes Episcopal Hospital Associate Professor of Medicine Clinical Associate Professor of Surgery at Houston Mt. Sinai School of Medicine Houston, Texas 77225 Director, Interventional Cardiology Research and Laser USA Angioplasty Program Mt. Sinai Hospital Douglas Losordo, M.D. Departments of Biomedical Research and Medicine 1 G. 1. Levy Place (Cardiology) Box 1030 New York, NY 10029 736 Cambridge Street USA Boston, MA02135 USA Mikhail Sargin, M.D. JohnA. Mallery, M.D. Senior Research Scientist Assistant Adjunct Professor of Medicine Dept. of Cardiac Surgery Acting Director, Coronary Care Unit A. V. Vishnevsky Institute of Surgery Cardiology/Surgery Liaison Serpukhovskaya 27 St. University of California, Irvine Moscow, USSR USA James M. Seeger, M.D. Marie-Clair Marroum, M.D. Associate Professor of Medicine Laser and Applied Technologies Laboratory Chief, Vascular Surgery Sanger Clinic Veterans Administration Medical Center 1960 Randolph Road Box]-286 ]HMHC Charlotte, NC 28207 College of Medicine USA University of Florida Mahmood Mirhoseini, M.D. Gainesville, Florida 32610 Assistant Clinical Professor USA x CONTRIBUTING AUTHORS Kathleen Seifert, M.S. University of Texas Laser and Applied Technologies Laboratory Engineering Science Building, Room 639 Carolinas Heart Institute Austin, TX 78712 Post Office Box 32861 Yasumi Uchida, M.D. Charlotte, NC 28232 Associate Professor of Medicine USA Head Section Cardiology Jay Selle, M.D. 2nd Division of Internal Medicine Chief, Vascular Surgical Service Ohno 3-1739-8 Department of Thoracic Cardiac and Vascular Surgery Ichikawa City Laser and Applied Technologies Laboratory Chiba Prefecture Sanger Clinic Japan 1960 Randolph Road MartinJ.C. van Gernert, Ph.D. Charlotte, NC 28207 Head, Laser Center USA Academic Hospital at the University of Amsterdam I. Nigel Sinclair, M.D. Academic Medical Center Department of Medicine Mei bergdreef 9 Cardiology Section 1105 AZ Amsterdam Zuidoost The Sir Charles Gardner Hospital The Netherlands Perth, Australia RudolfM. Verdaasdonk, M.Sc. Paul D. Smith, Ph.D. Heart-Lung Institute Cardiology Branch Department of Cardiology Bldg. 13, Room 3W13 University Hospital NIH Bethesda, MD 20892 Utrecht USA The Netherlands RichardJ. Spears, M.D. G. Michael Vincent, M.D. Associate Professor of Internal Medicine Associate Professor of Medicine Wayne State University School of Medicine Chairman, Department of Medicine Director, Cardiac Laser Program LOS Hospital Harper Hospital 8th Avenue and C street Louis Elliman Research Building Salt Lake City, UT 84143 421 East Canfield Sf. USA Detroit, Michigan 48201 A. J. Welch, Ph.D. USA Marion E. Forsman Centennial Professor Willem M. Star, Ph.D. Professor, Electronic Computer and Biomedical Department of Clinical Physics Engineering Dr. Daniel den Hoed Cancer Centre University of Texas Rotterdam Engineering Science Building, Room 639 The Netherlands Rodney A. White, M.D. Robert H. Svenson, M.D. Associate Professor of Surgery Medical Director, Laser Program Chief, Vascular Surgery Sanger Clinic Harbor/UCLA Medical Center 1960 Randolph Road 1000 W. Carson St. Charlotte, NC 28207 Torrance, CA 90502 USA USA George P. Tatsis, B.S. Geoffrey H. White, M.D. Associate Director, Laser Porgram Assistant Professor of Surgery Laser and Applied Technologies Laboratory Harbor/UCLA Medical Center Carolinas Heart Institute 1000 W. Carson St. Post Office Box 32861 Torrance, CA 90502 Charlotte, NC 28232 USA USA Biqing Ye Jonathan M. Tobis, M.D. Associate Professor Associate Professor of Medicine Shanghai Institute of Optics and Fine Mechanics Acting Chief, Division of Cardiology Chinese Academy of Sciences Director, Cardiac Catheterization Lab P.O. Box 8211 University of California, Irvine Shanghai, P.R. China Medical Center Bldg. 53 Samuel Zimmern, M.D. 101 City Drive S. Director Pacemaker Program Orange, CA 92668 Sanger Clinic USA 1960 Randolph Road Jorge H. Torres, M.D. Charlotte, NC 28207 Graduate Student USA
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