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A laser creates 20 to 45 small channels on the surface of the heart muscle to improve blood flow and reduce pain

Surgery Treats Previously Inoperable Heart Diseas
Laser Treatment Can Improve Quality Of Life For Angina Sufferers

Cardiothoracic surgeons of the Regional Heart Institute are now using transmyocardial laser revascularization (TMR), a new procedure used to treat inoperable heart disease in people with angina, at OSF Saint Anthony Medical Center.

Angina is chest pain or discomfort that occurs when the heart muscle does not get enough blood. Symptoms include pain that feels like pressure or a squeezing pain in your chest. Pain may also occur in the shoulders, arms, neck, jaw, or back. It can also feel like indigestion. Angina is itself a symptom of coronary artery disease.
Although most people with angina are treated with angioplasty, stents, coronary bypass surgery or medications, these treatments do not always eliminate angina. Until recently, patients had no choice but to put up with the pain.

“ TMR is a new surgical procedure that helps improve blood flow to areas of the heart that have not been improved by other treatments. It can be performed alone or at the same time as coronary bypass surgery,” said James R. Locher, MD, a member of Rockford Surgical Service and independent physician with the Regional Heart Institute. “During the procedure surgeons make a small incision between the ribs and use bursts of a special laser to create 20 to 45 small channels on the surface of the heart muscle. Each channel is about the size of the head of a pin. As the heart pumps oxygen-rich blood out of the heart, it begins to send blood through these new channels.”

The procedure may also promote the growth of new capillaries (small blood vessels) that help supply blood to the heart muscle.

TMR has shown clinical benefits for those who may require one or two bypass grafts, but have damaged areas of the heart that will not benefit from bypass surgery.

Candidates for TMR include those who:

• take medications but still have severe angina that limits their daily activities or causes them to wake from pain at night;
• have pre-operative tests that show ischemia (decreased blood supply to the heart muscle);
• have a history of previous bypass surgery or angioplasty, and additional procedures are not possible;
• have been told by their doctor that there is nothing that can be further done to help their symptoms.

After reviewing your medical condition and history, along with your test results, your doctor will decide if you are a candidate for the TMR procedure. If you are eligible, the doctor will discuss the benefits and risks.

A study published by The New England Journal of Medicine reported 72 percent of patients who had TMR experienced an improvement in angina symptoms after 12 months, compared to only 13 percent patients who were receiving medications for the treatment of their angina symptoms.