Dr. Batter and the Transmyocardial Revascularization

John T. Batter, M.D. cardiovascular and thoracic surgeon with the Alegent Health Heart and Vascular Institute Transmyocardial Revascularization, TMR, a surgical procedure performed at the Alegent Health Heart and Vascular Institute has been shown to reduce angina and improve the quality of life for patients with coronary artery disease.

The procedure uses a laser to make 20 to 45 "channels" or small holes, directly into the heart muscle, which then seal immediately. The channels are about the size of a sewing needle and about one-half inch apart.  It is unusual for any significant bleeding to take place as a result of the procedure, but any that occurs can usually be handled with the application of mild pressure at the channel site.

Although there is not a definitive answer as to why TMR works, according to clinical studies, but according to Dr. the channels promote growth of new blood vessels, which in turn can provide damaged heart tissue with an improved supply of blood and oxygen. Angina usually subsides with improved oxygen supply to damaged areas of heart muscle.

You may be a TMR candidate if:

• You have angina due to advanced cardiovascular disease
• Your physician believes that you are not a candidate for standard therapies such as balloon angioplasty or bypass surgery.
• Your heart muscle around the affect blood vessels is healthy.
• Your angina cannot be managed with medication, or the medications you are using are causing serious side effects.

You may not be a TMR candidate if:

• You are unable to undergo general anesthesia
• You have had a heart attack in the past 3 weeks
• Your heart rhythm cannot be controlled
• You have chronic obstructive pulmonary disease (COPD) or other debilitating lung disease
• You have congestive heart failure

Risks associated with TMR include those that would be associated with any chest surgery and you would need to discuss all risks and benefits with your physician prior to deciding to have the procedure.