[Transmyocardial laser revascularization. A new possible method for treatment of ischemic heart disease]

Transmyocardial laser revascularization (TMR) using a CO2 laser or a holmium YAG laser represents a novel approach to treating coronary artery disease. Through a left thoracotomy, 15-30 transmural channels approximately 1 mm in diameter, are created with the laser through reperfusable areas of the left ventricular free wall of the beating heart. This allows blood to flow directly from the left ventricle into the myocardial vascular network. The epicardial holes seal within few minutes. More than 1000 patients have had TMR worldwide. Indications are not fully established. Preliminary results suggest that TMR may be of value either as an adjunct to coronary bypass surgery, or in patients in whom another invasive treatment is not an option. Results from randomized, controlled studies are not yet available.