Ten-year follow-up after combined coronary artery bypass grafting and transmyocardial laser revascularization in patients with disseminated coronary atherosclerosis

A Comparative Analysis of Adjunctive Transmyocardial Laser Revascularization With Coronary Artery Bypass Grafting

Coronary artery disease (CAD), a chronic condition, is a leading cause of morbidity and mortality worldwide. It is characterized by plaque buildup in the coronary arteries, which can restrict blood flow and result in symptoms that can include chest pain and shortness of breath. Management of CAD often involves a combination of lifestyle modifications, medications, and revascularization such as coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and transmyocardial laser revascularization (TMLR). This meta-analysis examines the short-term and long-term benefits and outcomes of TMLR on angina severity when used as an adjunct to CABG in patients with CAD. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search and analysis was performed in the PubMed, BioMed Central, and ClinicalTrials.gov databases for relevant studies from database inception to February 2023. A comprehensive literature review and meta-analysis of current peer-reviewed studies suggest that adjunctive TMLR + CABG can significantly reduce angina severity and improve clinical outcomes for patients with CAD in the short term. Benefits include decreased lengths of stay in the intensive care unit, hospital length of stay, decreased operative mortality, and superior angina relief compared to CABG alone. Certain studies that evaluated long-term outcomes indicated the benefits of adjunctive CABG and TMLR were lost after one year; however, further investigation regarding long-term outcomes would be beneficial.