The heart is an organ for pumping of blood to the body, but even the heart and its muscle need its own blood supply to function well. The heart muscle gets its blood supply from its own arteries called coronary arteries. When these arteries get blocked, the result is coronary artery disease and angina (chest pain).
The first line treatment options for coronary artery disease include angioplasty and stenting or, coronary bypass surgery and medications that will enhance blood flow to the cardiac or heart muscle. If the above-mentioned procedures do not eradicate the symptoms of chest pain (angina), other treatment options are on hand to treat coronary artery disease.
Transmyocardial revascularization (TMR) is a recently developed technique for the treatment of coronary artery disease. It augments impaired blood flow to heart muscle tissue (also known as myocardial tissue) by means of a special carbon dioxide (CO2) or Holmium:YAG laser. The laser works to create miniature channels in the heart’s muscle, which helps blood flow easier to the heart. It finally relieves angina as well, which is chest pain caused by a lack of oxygen to the heart’s muscle tissue.
What is the procedure for transmyocardial revascularization (TMR) ?
Transmyocardial revascularization (TMR) is a surgical procedure, done via a small incision in either the left side or in the midline of the chest. Commonly, it is performed along with coronary bypass surgery, rarely alone. After the surgeon makes the incision, the heart muscle will be exposed. The hand piece which contains the laser beam is placed on that area of the heart that needs treatment. A specialized high-energy, computerized carbon dioxide laser is used to make twenty to forty one-millimeter-wide channels (about the width of a pin head) in the left ventricle (the lower pumping chamber in the left side) of the heart. The surgeon himself will decide how many channels to make in the procedure. The outer parts of the channels seal up, but the inside of the channels remain patent in the heart to recover its blood flow.The Carbon Dioxide Heart Laser utilizes a computer to guide laser beams to the right area of the heart amid heartbeats, because that is when the ventricle will be blood-filled and the heart is relatively motionless. This will prevent possible electrical disturbances (or arrhythmias) in the heart.
How does transmyocardial revascularization work ?
The exact mechanism is still being figured out but the two possible ways in which transmyocardial revascularization work are as follows.
- The channels function as bloodlines as the ventricle pumps oxygen-rich blood out of the heart, it forces blood through the channels and restores blood flow to the heart muscle.
- The surgical procedure may help angiogenesis, or the development of new capillaries (small blood vessels) that increase blood flow to the heart muscle. Transmyocardial revascularization usually takes one to two hours.
Who is a candidate for transmyocardial revascularization ?
Transmyocardial revascularization is recommended in individuals who have severe angina, which confines their daily activities, despite medications or have a history of previous bypass surgery or angioplasty with no more interventions available. Transmyocardial revascularization is inappropriate for patients whose heart muscle is severely damaged due to heart attacks, or whose the heart muscle is dead or too scarred rather than affected by inadequate blood supply (ischemic).
What are the tests needed to determine if you are a candidate for transmyocardial revascularization ?
Your complete medical history will have to be evaluated. Tests required prior to transmyocardial revascularization include the following.
- Cardiac catheterization: This is done in order to image your coronary arteries and see if any blockages are present.
- PET (Positron Emission Tomography) study
- Dobutamine Echocardiography
- Cardiac MRI
After doing a thorough review of your medical condition and history, along with your test results, your doctor will come to a decision if you are a candidate or not. If you are suitable, the doctor will discuss the benefits and risks of the procedure with you so can decide.
Does transmyocardial revascularization work ?
Most of the patients who had transmyocardial revascularization experienced an improvement in angina symptoms, with a dramatic relief of chest pain, an improved blood flow to the heart and an improved quality of life. Research is still underway to evaluate long-term outcomes in transmyocardial revascularization.
Will you have better health after transmyocardial revascularization ?
After transmyocardial revascularization, some patients feel instantaneous relief from angina symptoms, while others feel slow improvement over time. In some patients, even though their symptoms may not improve after Transmyocardial Revascularization, they will have better activity tolerance. After the procedure, you may still have to take medications. You will also have to visit your cardiologist for frequent follow-up visits so your progress can be determined.
How active can you be after transmyocardial revascularization ?
Your doctor will talk about specific activity guidelines that are suitable for you after your surgery. A cardiac rehabilitation program is suggested to help guide your recovery and help you increase your activity levels.
How to find and reach heart surgeons for transmyocardial revascularization procedure ?
Now you can find and reach heart surgeons for transmyocardial revascularization procedure from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple heart surgeons, cost estimates for transmyocardial revascularization procedure from different hospitals, compare things and then choose a heart surgeon for transmyocardial revascularization procedure.
Find, reach and choose a heart surgeon for transmyocardial revascularization procedure on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.