Transmyocardial Laser Revascularization (TMR)
Transmyocardial laser revascularization (also called TMR) is a treatment for patients with coronary artery disease who have not responded to or are not eligible for procedures such as angioplasty and stenting, medication, and coronary artery bypass graft surgery. For these patients, this surgical procedure is used to relieve angina (chest pain) that is generally caused by a lack of oxygen and blood flow to the heart.
During the procedure, the surgeon makes a small incision in the left side of the chest and uses a special laser to create channels in the heart muscle which will improve blood flow. A computer directs the laser beams to the appropriate area of the heart in between heartbeats, which helps prevent electrical disturbances
The advantage of TMR is that it provides a last-resort option to patients with severe angina (chest pain). It can be especially effective in patients with other conditions - such as diabetes – that make it impossible to do bypass surgery. Although clinical data are still somewhat limited, 80 to 90 percent of patients have seen significant improvement in their symptoms (at least a 50 percent improvement) at one-year follow up. A New England Journal of Medicine study concluded that patients who had TMR had relief of chest pain as well as improved quality-of-life, improved blood flow to the heart, and decreased hospital admissions.