Transmyocardial revascularization

Transmyocardial revascularization (TMR) is a surgical procedure used to treat angina when no other treatments work. This procedure is generally reserved for people with severe, diffuse coronary artery disease who aren't candidates for angioplasty or coronary artery bypass surgery.

Procedure

During TMR, a surgeon uses a laser to make small channels in the heart muscle, improving blood flow to the heart muscle. The procedure is performed either as a standalone procedure or in conjunction with coronary artery bypass graft (CABG) surgery.

Indications

TMR is indicated for patients with severe angina that is not relieved by medication and who are not suitable candidates for angioplasty or coronary artery bypass surgery. It is also used in patients who have had previous bypass surgery but continue to have angina.

Benefits

The benefits of TMR include a reduction in angina symptoms, improved exercise tolerance, and improved quality of life. Some studies have also shown that TMR can reduce the need for anti-anginal medication.

Risks

As with any surgical procedure, TMR carries risks. These include infection, bleeding, irregular heart rhythms, and in rare cases, death. The risk of complications is higher in people with other health conditions such as diabetes or lung disease.

Alternatives

Alternatives to TMR include medication, angioplasty, and coronary artery bypass surgery. However, these options may not be suitable for all patients, particularly those with severe, diffuse coronary artery disease.

See also

• Angina
• Coronary artery disease
• Coronary artery bypass surgery
• Angioplasty

Transmyocardial revascularization Resources
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