For patients with coronary artery disease who are not candidates for bypass surgery, Washington University heart surgeons offer transmyocardial laser revascularization, or TMR, to relieve chest pain.

TMR was developed for people whose vessels cannot be bypassed and whose angina is not relieved by medications or other treatments.

Before the procedure, those who had this set of medical problems were in a hopeless situation because they had no other options.

Angina is chest pain or pressure that patients often describe as feeling as if an elephant is sitting on their chests. It is an indicator of artery blockages or coronary artery disease.

During TMR, heart surgeons make small holes through the patient’s heart with lasers to improve blood flow through the heart and other vessels. The lasers also can deaden nerves so patients feel less pain from angina.

With this surgery, 85% of patients have complete relief of angina or feel some improvement. The procedure can dramatically improve the quality of life for those who are crippled by chest pain.

Washington University School of Medicine and Barnes-Jewish Hospital were part of a nationwide trial for TMR. The procedure is approved by the Food and Drug Administration.

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