Transmyocardial Revascularization (TMR)

A revolutionary laser for the treatment of heart disease is now being performed at Carle Foundation Hospital in Urbana, IL. TMR (Transmyocardial Revascularization) using The Heart Laser™ System is a procedure for coronary artery disease patients suffering from severe angina who are not treatable by conventional coronary revascularization techniques (e.g. bypass surgery and angioplasty). The Heart Laser System™ is the only TMR product approved by the Food and Drug Administration in the United States.

"This is a major advancement in the treatment of severe coronary artery disease. I can assure you that its availability in East Central Illinois is a significant benefit for those people with heart disease who have run out of treatment options," said L. Scott Cook, M.D., cardiovascular surgeon at Carle.

"The typical TMR candidate is immobilized by angina (chest pain) and shortness of breath and fatigue. Traditional surgery is not feasible and a daily, heavy dose of drug therapy is not enough. TMR is a chance for a better life," Dr. Cook explained.

Each year, an estimated 80,000 Americans are diagnosed with severe coronary artery disease (CAD), which is not treatable by conventional coronary revascularization techniques (e.g. bypass surgery and angioplasty). CAD is a form of heart disease caused by blockage of blood flow into the coronary arteries, which supply oxygen-rich blood to the heart muscle. It can lead to heart attack and is the major cause of death in the US. About 500,000 Americans die from CAD annually.

TMR using The Heart Laser System™, developed by PLC Medical Systems Inc., a subsidiary of PLC Systems Inc., of Franklin, Mass., is a new way of restoring oxygen-rich blood flow to the heart. TMR using the high-energy, carbon dioxide (CO2) laser creates new channels believed to restore blood flow. The computer-controlled laser is synchronized with the heartbeat and automatically triggered to fire when the heart is relatively still and unresponsive to stimuli.

In US clinical studies, TMR using The Heart Laser System™ was shown to be safe and effective in decreasing angina by two or more classes (angina is measured in classes from one to four, one being the least painful and four being the worst) in nearly 75 percent of study patients, and eliminating all angina in one-third of patients.

TMR using The Heart Laser System™ is performed on a beating heart, generally through a small left chest incision. The one-pulse Heart Laser System™ is used to create between 20 and 40 one-millimeter-wide channels through oxygen-deprived heart muscle (myocardium), into the heart's left ventricle, allowing blood to flow into the heart muscle again, despite blocked arteries.

TMR using The Heart Laser System™ is considered less invasive heart surgery. It usually involves a small left chest incision; generally does not necessitate a blood transfusion; and, because it is performed on a beating heart, does not require the use of a heart-lung machine. Therefore, recovery is potentially quicker and less traumatic than in open-heart procedures.

Available through a lease arrangement, use of the equipment will cost Carle Foundation Hospital a minimum of $70,000 during this first year or $3500 per procedure. According to the contractual agreement, the cost will escalate in subsequent years. It is expected that 20-40 procedures will be performed annually at Carle.

The Carle Heart Center offers a full range of the most advanced cardiac diagnostic and treatment options. "With the addition of TMR surgery, we are capable of offering our patients nearly every option available in advanced heart care today—right here in Urbana," concluded Dr. Cook. Dr. Cook joined Carle in l990. The physician staff of the Carle Heart Center includes 3 cardiovascular and thoracic surgeons, and 10 cardiologists.