Hospital's cardiac surgeons use advanced CO2 laser for transmyocardial revascularization (TMR) to treat coronary artery disease
Winthrop-University Hospital's cardiac surgeons recently broke new ground in cardiac care on Long Island by using a sophisticated, high-energy, computerized CO2 Heart Laser when treating advanced heart disease patients who may have run out of treatment options.
Coronary artery disease (CAD) occurs when the arteries carrying blood to the heart muscle become obstructed and prevent the organ from receiving the amount of oxygen-richich blood it needs to pump blood to the rest of the body. The resulting chest pain (angina) occurs because the heart isn't getting enough blood and oxygen.
Patients with CAD are usually treated with such interventional procedures as angioplasty and stenting, coronary artery bypass surgery and medications to improve blood flow to the heart muscle. If these procedures do not alleviate the severe, persistent angina, transmyocardial revascularization (TMR) is considered.
A surgical procedure, TMR is performed with a special carbon dioxide laser that creates tiny channels (about the width of the head of a pin) in the heart wall. The technology's computer directs laser beams to the appropriate area of the heart, with the laser pulses synchronized to match the heartbeat so the channels are created when the heart is at rest and filled with blood.
"The CO2 laser is the ideal tool for TMR because the channels can be made quickly, and the timed laser pulse helps prevent damage to other tissue in the heart," explained Scott Schubach, MD, Chairman of Winthrop's Department of Thoracic & Cardiovascular Surgery.
He continued, "The procedure is performed through a small incision in the left chest or through a midline incision. It is often used along with coronary artery bypass in patients who may need one or two bypass grafts, but also have areas of the heart that we can't bypass with direct surgery; sometimes we use TMR without open heart surgery."
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How TMR reduces angina is not fully understood. Clinical evidence suggests that TMR may promote the increase of blood flow by stimulating the growth of new blood vessels (angiogenesis) within the heart. Or, the newly created channels in the heart muscle supplement the work of the diseased arteries, with the heart feeding itself by taking blood from within its chambers.
TMR is a treatment option for patients who:
- Have severe chest pain that limits daily activities or causes pain despite medication.
- Show decreased blood flow to the heart muscle.
- Have had heart bypass surgery or angioplasty, and have been told that nothing more can be done to relieve their chest pain.
The procedure is not suitable for people with severely damaged or scarred heart muscles or for those who show no signs of inadequate blood supply to the organ.
TMR patients usually remain hospitalized several days, depending on overall health and rate of recovery. "Most patients feel relief from chest pain soon after the TMR procedure, while others begin to notice improvement within weeks," reported Dr. Schubach. "Usually, within 12 months aftng blood from within its chambers.
TMR is a treatment option ff is a treatment option fer surgery, patients feel much better and experience improved quality of life."
Winthrop ranks in the top 5 percent of the nation for overall cardiac services, and has been named one of the finest heart care institutions in America by HealthGrades(R), the national healthcare quality experts.
For more information, call 1-866-WINTHROP or Winthrop's Institute for Heart Care at 1-800-443-2788.