Memorial Cardiac & Vascular Institute
Transmyocardial Revascularization (TMR)
What is transmyocardial revascularization?
Transmyocardial revascularization or TMR is a surgical procedure that is used to relieve angina (chest pain). It may be performed alone or in conjunction with a coronary bypass.
What happens during the procedure?
When TMR is performed in conjunction with a coronary bypass, the incision is made through the sternum. Otherwise, the incision is made on the left side of the chest.
Once the incision is made, the surgeon uses a carbon dioxide laser beam to create anywhere from 20 to 40 one-millimeter channels in the heart muscle. These channels improve blood flow and relieve pain.
How does TMR relieve pain?
Scientists are uncertain as to the pain-relieving mechanism behind TMR. It is believed the laser may destroy the nerves that create pain, or the laser may encourage the growth of new, healthy blood vessels.
Who should undergo TMR?
Many patients with angina can be successfully treated with medication, angioplasty or a coronary bypass. TMR becomes an option when these other treatments are not feasible or when they have failed to yield the desired results.
Examples of TMR candidates include:
- Patients who have diffuse blockages
- Patients who have developed atherosclerosis following a heart transplant
- Patients who are at risk for complications resulting from a second bypass or angioplasty
Because TMR is a fairly new procedure, the long-term effects are still unknown. However, studies show that most TMR patients experience a dramatic reduction in pain during the year that follows their surgery.
Online Resources
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.
- American College of Cardiology
- American Heart Association
- National Heart, Lung, and Blood Institute (NHLBI)
- National Institutes of Health (NIH)
- National Library of Medicine
- Society of Thoracic Surgeons
Click here to view the Online Resources of Heart Center.
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