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Correspondence
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Volume 342:436-438 February 10, 2000 Number 6
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Transmyocardial Laser Revascularization

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 by Allen, K. B.
To the Editor: The placebo effect of surgery for the treatment of angina that is mentioned by Lange and Hillis (Sept. 30 issue)1 in their editorial on transmyocardial laser revascularization deserves elaboration. In the era before direct coronary revascularization, internal-thoracic-artery ligation was touted as a method to increase myocardial blood flow and relieve anginal symptoms. Initial reports by Ellis et al.2 and Kitchell et al.3 indicated that 68 to 75 percent of patients had clinical improvement, including approximately 35 percent who had complete relief and 42 percent with objective improvements, as measured electrocardiographically. These investigators were honest and intelligent but . . . [Full Text of this Article]

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