Some patients have severe narrowing throughout the length of their coronary arteries. This situation cannot be improved or corrected by a bypass or an angioplasty. For some time now, the only option for such patients whose symptoms cannot be controlled with medications was a heart transplant.
A new procedure is now available for these patients. Transmyocardial laser revascularization is done by placing a laser probe directly on the surface of the heart. The laser is used to create multiple channels that extend through the heart muscle into the main pumping chamber of the heart. These channels fill with blood from the pumping chamber which then supplies oxygen and needed nutrients to the heart muscle. The procedure takes about 2 hours. About 75% of patients undergoing the procedure have a marked improvement in their symptoms but it may take about 3 months before the improvement occurs.
A new, less invasive method places a catheter into the heart through an artery and creates the channels from inside the heart. This is known as percutaneous TMR and avoids the need to open the chest. However, a research study presented in 2000 found that this procedure was of no clinical benefit.
The idea for this procedure came from studying reptilian hearts. Reptiles don't really have coronary arteries but supply blood to their heart muscle through channels that extend from the cavity of the main pumping chamber of their heart.
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