For those patients with coronary artery disease who are not candidates for bypass surgery, Washington University cardiac surgeons offer another option — transmyocardial laser revascularization, or TMR.
TMR was developed for people who don’t have vessels that can be bypassed or whose angina (pain) is not relieved by medications or other treatments,” says Marc Moon, M.D., Washington University cardiac surgeon at Barnes-Jewish Hospital.
“Before this procedure — even just a year ago — people with severe angina were in a hopeless situation because they had no other options.”
Angina is chest pain or pressure which is often described as a feeling of an elephant sitting on your chest, Dr. Moon says. It is an indicator of artery blockages or coronary artery disease.
During TMR, cardiac surgeons make small holes through the patients heart with lasers to improve blood flow through the heart and other vessels. The lasers can also deaden nerves so patients feel less pain from angina.
“With this surgery, 85% of patients can have complete relief of angina or at least feel some improvement,” Dr. Moon says. “Many people are crippled by angina pain, but this procedure can dramatically improve their quality of life. It won’t replace bypass surgery but for those people with no other options, this is a significant medical breakthrough.”
Washington University School of Medicine and Barnes-Jewish Hospital were part of a nationwide trial for TMR five years ago. In 2000, the Food and Drug Administration approved the procedure.