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TMR spells relief for severe angina

Try saying this three times fast: percutaneous transmyocardial revascularization (TMR). This medical tongue twister defines an innovative new procedure for severe angina patients who cannot undergo bypass surgery or angioplasty.

Angina is a symptom of coronary artery disease that often precedes a heart attack. It’s marked by painful chest tightening or pressure that lasts up to 15 minutes, then subsides. Some episodes occur after activity or exertion; others come during rest.

Although a rather new procedure, TMR already has shown exceptional results. One year after undergoing TMR, as many as 90 percent of patients reported that their pain had subsided by at least half. However, physicians caution that long-term data aren’t yet available to determine if the effect lasts more than a few years.

To perform the procedure, surgeons open the left side of the patient’s chest to expose the heart. They then use a surgical laser to “drill” 20 to 40 tiny holes through the heart’s outer wall into the pumping chamber. TMR occasionally is performed in conjunction with bypass surgery to treat multiple symptoms.

Why TMR spells relief for patients isn’t yet fully understood. Some doctors believe the procedure stimulates the growth of new blood vessels in the heart to replace diseased ones. Others think the laser kills nerve fibers so that angina pain is no longer felt. Three classes of patients are good candidates for TMR: patients for whom a second bypass or angioplasty procedure is high risk, patients with many blockages and heart transplant patients who develop coronary disease.

Of course, your doctor can provide you with detailed information about TMR. And if you suffer any anginalike symptoms, such as pain throughout your chest that radiates to your arms, neck or back or feels like indigestion, contact your doctor at once. Effective angina treatment could involve a hospital stay for tests and therapy.