Transmyocardial laser revascularization (TMLR)

A treatment for ANGINA PECTORIS and ISCHEMIC HEART DISEASE (IHD) in which the cardiovascular surgeon uses a laser to create several dozen tiny channels through the wall of the heart’s left ventricle to improve the flow of BLOOD and oxygen to the MYOCARDIUM (heart MUSCLE). The surgeon makes a small “window” incision through the ribs to gain access to the myocardium, and the HEART continues to beat during the surgery. The channels allow blood to flow directly from the ventricle’s chamber to the muscle tissue. Researchers do not know why TMLR relieves angina pectoris, though believe it allows oxygen to directly enter myocardial cells and also encourages new blood vessels to grow (collateral circulation). Cardiologists generally use TMLR only when other treatments for angina have failed or are not feasible. Most people stay in the hospital for three to seven days following surgery and are able to return to their regular activities, including work, in four to eight weeks.

See also CORONARY ARTERY BYPASS GRAFT (CABG); SURGERY BENEFIT AND RISK ASSESSMENT.

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