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Transmyocardial Laser Revascularization (TMR)
St. Edward Mercy Medical Center is on the cutting edge of technology utilizing Transmyocardial Laser Revascularization (TMR). TMR is a minimally invasive procedure used to relieve severe angina or chest pain in very ill patients by restoring blood flow to disease areas of the heart in patients who are not candidates for bypass surgery or angioplasty.
In this procedure, a surgeon makes an incision on the left breast to expose the heart. Then, using a laser, the surgeon drills a series of holes from the outside of the heart into the hearts pumping chamber. How TMR reduces angina is still not fully understood, but theories are: the laser may stimulate new blood vessels to grow or it may destroy nerve fibers to the heart, making patients unable to feel their chest pain.
This is a new treatment for chest pain sufferers. Many advanced heart disease patients suffering from this form of chest pain have undergone a variety of treatments including coronary artery bypass grafting surgery (CABG), angioplasty and many different types of drug therapies. This revascularization procedure is performed by using the revascularization CO2 laser to create conduits or channels in the heart muscle. This treatment assists in providing blood to the areas of the heart that is not amendable to direct revascularization. Many people who have been suffering from angina or coronary artery disease may find this procedure beneficial in improving their quality of life. Clinical trials have resulted in patients experiencing relief of chest pain, improvement in blood flow to the heart, reduction in the number of hospital admissions for heart-related problems. St. Edward Mercy Medical Center is the first in the State of Arkansas to offer this state of the art technology.
The Society of Thoracic Surgery (STS) says:
“TMR provides very gratifying symptomatic improvement to desperately ill patients who otherwise would be crippled by unrelenting angina pectoris.”
Benefits and Positive Outcomes of TMR:
- Patients reported a significant improvement of 150% over baseline results in exercise capacity, angina stability, angina frequency, treatment satisfaction, and disease perception
(Horvath KA, et al. Sustained angina relief 5 years after transmyocardial laser revascularization with a CO(2) laser. Circulation 2001;104(12 Suppl 1):I81-4)
- Unstable angina reduced by 72% and Quality of Life increased by 91%
(The New England Journal of Medicine Vol. 341:14:1021:-1028)
- Discontinuation or halving of Nitrite Medication in 60% of Patients
- Readmission to the hospital was cut from 62% to 14% for treatment of unstable Angina. (The New England Journal of Medicine Vol. 341:14:1021:-1028)
If you would like to watch a video of the TMR please click here.
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