Transmyocardial Laser Revascularization (TMR) uses a laser beam to improve blood flow to the heart muscle, often relieving symptoms in people who are no longer good candidates for surgery or angioplasty. TMR does not require stopping the heart, and is done through a small incision instead of through open-chest surgery. This technique usually is only done when persistent, severe angina cannot be controlled with medication or treated with bypass surgery or percutaneous coronary intervention (PCI), which includes angioplasty with or without stent placement or atherectomy.
- In this technique, a laser beam is used to create tiny channels in the wall of the heart. The initial concept of TMR was that blood supply would flow through these channels and supply oxygen to the heart muscle. The mechanism by which TMR works is not well-understood. TMR appears to reduce angina and improve exercise tolerance and quality of life.
- Some studies suggest that it improves blood flow to the heart muscle, while other studies do not. Some investigators believe that the channels seal off, but that new blood vessels then grow in around the scar, improving blood flow. Others believe that TMR works by reducing the number of nerve fibers that conduct the pain of angina. This treatment is neither widely available nor appropriate for everyone. It is best suited for people who have blocked arteries that cannot be treated using bypass surgery or angioplasty.
Condition Details :
Coronary heart disease (CHD), also called coronary artery disease (CAD), ischaemic heart disease, atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. It is the # 1 killer in the U.S. While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arise. After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death[1], and is also the most common reason for death of men and women over 20 years of age.There are often no typical symptoms as they are well known for coronary heart disease; Cardiac Syndrome X often is a diagnosis of exclusion.
