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An emerging minimally invasive technique for narrowed coronary arteries called transmyocardial revascularization (TMR) is under investigation by surgeons at the Texas Heart Institute in Dallas and elsewhere. The procedure is simpler and costs are lower than bypass and angiography.
In TMR, surgeons use a high-powered carbon dioxide laser to create tiny holes in the heart muscle. The holes become channels, allowing blood from the left ventricle to flow to the diseased portion of the heart created by the narrowed or blocked arteries.
The procedure not only increases blood flow to obstructed areas of the heart, but also improves function in the left heart chamber, reduces cardiac pain, reduces need for medication, and improves quality of life. TMR may offer hope to patients with occlusions formerly considered untreatable and to those ineligible for bypass surgery or angioplasty.
Swedish researchers recently compared laser guide wires with nonlaser mechanical guide wires for the treatment of chronic coronary total occlusions, and the laser devices increased the success rate by 35%. Their clinical trial on 300 patients demonstrated no increased risk of complications. U.S. Surgical in Colorado Springs, CO, is seeking FDA approval for a device called Prima that utilizes that technology.