What is TMR?

TransMyocardial Revascularization is a surgical technique used to improve the blood supply to areas of the heart that do not receive enough oxygen. At Baptist Hospital, cardiothoracic surgeons use a high-powered, carbon dioxide laser to create small channels that allow blood to flow from within the hearts pumping chamber directly into the heart muscle. These new channels are called bloodlines. Through them, blood flow is restored to the oxygen-deprived heart muscle.


TMR uses the precision, computer-controlled laser to create a series of small channels, each about 1 mm in diameter, from the outside to the inside of the heart. The procedure is performed through a small opening in the chest by placing a laser directly on the heart muscle. An EKG is used to time the release of the laser beams into the heart. When TMR is performed as a sole therapy, it takes about two hours to complete and does not require the support of a heart-lung machine. When TMR is combined with traditional bypass surgery, it may require a slightly larger incision but can still be performed on a beating heart, adding an additional 15-30 minutes.

When is TMR an option?
The heart needs a regular supply of oxygen which it receives through the coronary arteries. Atherosclerosisblockages in the arteriesprevents proper blood supply to the heart. As a result, pain known as angina can occur. Medication is usually the first course of action to relieve or control the pain of angina. When medication is not effective, angioplasty may be an option. Open heart bypass surgery becomes an alternative when other treatments are ruled out.

TMR is a possibility when these more traditional methods of treatment have been exhausted.

How was TMR developed?
TMR is based on reptilian anatomy. Unlike humans, the reptilian heart gets its blood supply by direct flow from inside the heart through channels in the heart muscle wall. The carbon dioxide laser uses just the right amount of energy to create channels in the human heart for blood to flow directly into the heart muscle similar to reptilian physiology. The heart no longer relies on the blocked arteries to supply the blood and oxygen. Creation of these holes with the laser is thought to encourage the growth of other small blood vessels within the muscle wall. This process is called angiogenesis.

Are you a candidate for TMR?
TMR is considered for people with severe angina that occurs while resting or with mild exertion. These individuals may be candidates if medication offers no relief from pain, and if the size, location, number of blockages, or any combination of these factors, prevents traditional treatment. A surgeon determines if an individual is able to undergo the surgery. TMR offers a chance for pain relief and improved quality of life for patients who have no other options.

What are the Benefits of TMR?
Clinical trials have shown that TMR patients experience a marked improvement in their level of angina pain. During recovery, patients generally experience some pain for a few days, but as the heart heals, benefits of increased blood flow become evident. Typically, patients report considerable improvement about three months after the surgery. Most will see a reduction of two or more angina classes within the first year, and many become completely free of pain. Patients once limited by pain are often able to return to their normal activities of daily living. Studies also indicate improved exercise tolerance and quality of life.

Learn more about TransMyocardial Revascularization by talking with your physician or call Baptist HealthSource at (850) 434-4080.

 

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