Feedback

Transmyocardial Revascularization

Joshua L. Chan, MD, Keith A. Horvath, MD
Transmyocardial Revascularization is a topic covered in the Adult and Pediatric Cardiac.

To view the entire topic, please or .

STS Cardiothoracic Surgery E-Book from The Society of Thoracic Surgeons provides expert guidance for Cardiac and Thoracic Surgery. Sections include Pearson’s General Thoracic, Esphageal, Adult Cardiac, and Pediatric and Congenital Cardiac Surgery. Explore these free sample topics:

-- The first section of this topic is shown below --

Abstract

An increasing number of patients with advanced, diffuse coronary artery disease suffer from unremitting chronic angina pectoralis. The management of this condition remains a challenge, particularly in patients who experience symptoms refractory to maximal medical therapy. This severe coronary artery disease can lead to incomplete revascularization following coronary artery bypass surgery (CABG), a powerful predictor for perioperative mortality and adverse events. Transmyocardial laser revascularization (TMR) has emerged as a surgical option for patients who have exhausted nonsurgical therapies and are not amenable to complete revascularization. TMR, whether used as sole therapy or in conjunction with CABG, has been demonstrated to provide significant symptomatic angina relief and improve overall patient outcomes. As reflected by practice guidelines issued by the Society of Thoracic Surgeons (STS), consideration for TMR+CABG is warranted in select patients with chronic refractory angina pectoralis despite optimal pharmacological and interventional therapies.

-- To view the remaining sections of this topic, please or --

Abstract

An increasing number of patients with advanced, diffuse coronary artery disease suffer from unremitting chronic angina pectoralis. The management of this condition remains a challenge, particularly in patients who experience symptoms refractory to maximal medical therapy. This severe coronary artery disease can lead to incomplete revascularization following coronary artery bypass surgery (CABG), a powerful predictor for perioperative mortality and adverse events. Transmyocardial laser revascularization (TMR) has emerged as a surgical option for patients who have exhausted nonsurgical therapies and are not amenable to complete revascularization. TMR, whether used as sole therapy or in conjunction with CABG, has been demonstrated to provide significant symptomatic angina relief and improve overall patient outcomes. As reflected by practice guidelines issued by the Society of Thoracic Surgeons (STS), consideration for TMR+CABG is warranted in select patients with chronic refractory angina pectoralis despite optimal pharmacological and interventional therapies.

There's more to see -- the rest of this entry is available only to subscribers.

Last updated: March 18, 2020