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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.
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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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