When is transmyocardial laser revascularization considered?
Transmyocardial laser revascularization (TMR) is a treatment aimed at improving blood flow to areas of the heart that were not treated by angioplasty or surgery, or in which surgery, such as coronary bypass, will not complete treatment. Patients with coronary artery disease are treated with interventional procedures (angioplasty and stenting), coronary artery bypass grafting, and medications to improve blood flow to the heart muscle. Sometimes these procedures do not eliminate the symptoms of chest pain; TMR is another treatment option. A special carbon dioxide (CO2) laser is used to create small channels in the heart muscle, improving blood flow in the heart. The procedure is performed through a small left chest incision or through a midline incision. Frequently, it is performed with coronary artery bypass surgery, but occasionally it is performed independently.
How does it work?
How TMR reduces angina is not fully understood. The laser may stimulate new blood vessels to grow and/or it may destroy nerve fibers to the heart, making patients unable to feel their chest pain. TMR will not replace coronary artery bypass or angioplasty as the most common method of treating coronary artery disease. These alternatives have been proven over time to be safe, effective ways to restore blood flow to the heart muscle. However TMR can be considered in:
- People who are high-risk candidates for a second bypass or angioplasty.
- People whose blockages are too diffuse to be treated with bypass alone.
- Some patients with heart transplants who develop atherosclerosis in their transplanted heart.
David Bull, MD, is a member of the Thoracic Oncology Program, a joint effort between Huntsman Cancer Institute and the University of Utah Hospitals and Clinics. The program was developed to offer consultation, diagnosis, and treatment for all chest cancers. Bull is a professor in the Department of Surgery, Division of Cardiothoracic Surgery; progra... Read More
Dr. Burch performs repairs for a wide variety of congenital cardaic anomalies. In additon to clinical responsibilities, Dr. Burch has research interests in single ventricle physiology as well as in derangements in normal neonatal metabolism caused by cardiac surgery.... Read More
I joined the University of Utah, Division of Pediatric Cardiothoracic Surgery in 2012. I am board certified by the American Board of Surgery and the American Board of Thoracic Surgery. My clinical interests are focused on caring for all patients, from neonates to adults, with congenital heart defects. I have a special interest in pediatric heart... Read More
Dr. McKellar is a native of Salt Lake City and received his Bachelor of Arts from the University of Utah and his Doctor of Medicine from the George Washington University School of Medicine. He completed his General Surgical and Cardiothoracic Surgical training at the Mayo Clinic in Rochester, Minnesota in a combined, integrated training program. ... Read More
Cardiac Mechanical Support, Cardiothoracic Surgery, Coronary Revascularization, Heart Failure, Heart Transplant, Lung Transplant, Minimally Invasive Heart Surgery, Minimally Invasive Lung & Esophageal Surgery, Valvular Heart Disease
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Dr. Craig Selzman is a Professor of Surgery and Chief of the Division of Cardiothoracic Surgery at the University of Utah who specializes in the care of patients requiring heart surgery. He earned his undergraduate degree at Amherst College and medical degree at Baylor College of Medicine. He received his General and Cardiothoracic Surgery training... Read More
Adult Congenital Heart Disease, Cardiac Mechanical Support, Cardiothoracic Surgery, Coronary Revascularization, Heart Failure, Heart Stem Cell Therapy, Heart Transplant, Lung Transplant, Minimally Invasive Heart Surgery, Surgical Ventricular Restoration, Valvular Heart Disease
Dr. Thomas Varghese Jr. is the Head of the Section of General Thoracic Surgery, Division of Cardiothoracic Surgery at the University of Utah. He is the Program Director of the Cardiothoracic Surgery Residency, Co-Director of the Thoracic Oncology Progam at the Huntsman Cancer Institute, and an Associate Professor in the Department of Surgery, Unive... Read More
Cardiothoracic Surgery, Nurse Practitioner
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Scott came to the University almost 9 years ago from private practice. As a trainer and consultant for Endoscopic Vein harvesting, he has effectively introduced and incorporated new technology and procedures into the University healthcare system. As the senior physician assistant in the division of cardiothoracic surgery, Scott has 17 years experie... Read More