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.
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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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
Cardiothoracic Surgery, Nurse Practitioner
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