Sarasota Cardiac & Thoracic Surgery

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Transmyocardial revascularization, or TMR, is a procedure used to relieve severe angina or chest pain. It is reserved for patients who will not benefit from bypass grafts or angioplasty alone. In this procedure, your surgeon makes an incision on the left chest wall to expose the heart. Then, using a laser, your surgeon drills a series of holes from the outside of the heart into the heart's pumping chamber. Anywhere from 20 to 40 laser channels are placed during the procedure. In some patients TMR is combined with bypass surgery. In these cases an incision through the breastbone is used. How TMR reduces angina still isn't fully understood. The laser may stimulate new blood vessels to grow, called angiogenesis (an"je-o-JEN'eh-sis). It may destroy nerve fibers to the heart, making patients unable to feel their chest pain.

It has shown to be effective in 80-90% of patients after one year. You may be a candidate if:

• You are a high-risk candidate for a second bypass or angioplasty.
• You have blockages that are too diffuse to be treated with bypass alone.
• You have had a heart transplant and have developed blockages after your transplant.