What is transmyocardial revascularization?
Transmyocardial revascularization, or T.M.R., is a procedure designed to relieve severe angina or chest pain in patients who aren't candidates for bypass or angioplasty.

How is it done?
To do this procedure, a surgeon creates an incision under the left breast to expose the heart. Using a laser, a surgeon drills a series of holes from the outside of the heart into the heart's pumping chamber. From 20 to 40 1mm laser channels are placed during the procedures. Bleeding from the laser channels on the outside of the heart stops after a few minutes of pressure from the surgeon's finger. In some patients T.M.R. is combined with bypass surgery and in those instances an incision through the breastbone is used.

Clinical Outcomes
Evidence that T.M.R. relieves angina and improves blood flow to the heart comes from a number of clinical and animal studies. The T.M.R. procedure is well tolerated and lasting benefits can be expected in about 70 - 80% of patients in whom surgery is indicated.

What to expect
The night before surgery you will be allowed to eat dinner. Nothing to eat or drink after midnight except for small sips of water with medication. No aspirin products. Sleeping pills will be provided if needed. Fleets enema will be prescribed. Antibacterial soap should be used for last shower. You will be called by the ambulatory surgery unit and told what time to come to the hospital the next morning. The operating room has been specially prepared for your surgery. The anesthesiologist will give you medication shortly before your surgery begins which will make you drowsy. After you are asleep a breathing tube will be inserted and your breathing will be taken over by a ventilator (breathing machine). After surgery you will go to the Intensive Care Unit for 24 hours. The breathing tube will be discontinued when you are fully awake. From the intensive Care Unit you will be transferred to a private room on the cardiothoracic Surgery Unit. You will be in the hospital for 4 - 5 days.

In addition to the cardiothoracic surgeon the following personnel will help care for you: nurse practitioners, specially trained cardiac surgery nurses, pharmacists, music therapist, physical therapist, respiratory therapist, dietician, discharge planning nurses and cardiac rehabilitation nurses.

If you would like additional information or would like to make an appointment, call 847.570.2868.

Cardiothoracic Surgery:
2650 Ridge Avenue
Evanston, IL 60201

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