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TMLR (transmyocardial laser revascularization)TMLR is a surgical treatment for severe coronary artery disease, which interrupts normal flow of oxygen-rich blood to the heart. Today, TMLR is most often used in combination with coronary bypass surgery when small blood vessels supplying the heart are severely diseased, a bypass graft is not suitable in a certain area of the heart or laser revascularization is believed necessary to ensure adequate blood flow. Laser revascularization utilizes a laser to cut channels in the heart muscle, thereby improving blood supply. The TMLR procedure takes advantage of self-perfusion, a naturally occurring phenomenon in which the left ventricle (one of two lower heart chambers) provides a small supply of blood to the rest of the heart. The laser cuts new channels from the surface of the heart covering the left ventricle through to the ventricular cavity. The channels act like small blood vessels allowing passage of additional oxygen-rich blood from the left ventricle to other areas of the heart muscle. An adequate blood supply can then help prevent angina or heart attack. A laser, rather than a scalpel, is the ideal tool for revascularization. The channels can be made quickly with little damage to surrounding tissue. Studies have shown that after surgery the channels remain open, continuously providing the heart with more blood and oxygen. Initial TMLR clinical trials began in 1984 at Aurora St. Luke's Medical Center. Using a smaller incision in the chest and a special high-powered laser, TMLR is currently being studied as a treatment by itself for coronary artery disease. Candidates include patients with severe coronary artery disease whose disease is widespread or who have remaining symptoms after previous surgery. TMLR may also be appropriate for patients who have no other treatment options. [ Previous page ] |
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