Transmyocardial laser revascularization and angiogenesis: the potential for therapeutic benefit

Transmyocardial laser revascularization (TMR) has emerged as a promising therapy for ischemic heart disease in patients who are not candidates for more conventional therapies such as percutaneous transluminal coronary angioplasty or coronary artery bypass grafting. Although TMR provides symptomatic relief of angina and improved cardiovascular performance in a select patient population, the mechanism by which TMR works is still a controversial issue. Recently, it has been postulated that TMR evokes an angiogenic response and thereby improves local perfusion to ischemic myocardial territories. Herein we present a review of TMR and the molecular basis of angiogenesis.