We report the case of a 59-year-old woman who presented with symptoms of angina that was refractory to medical management. Although her cardiac catheterization revealed microvascular coronary artery disease, her symptoms were refractory to optimal medical management that included ranolazine. After undergoing transmyocardial revascularization, her myocardial ischemia completely resolved and her ...

revascularization, there is a growing population of patients who are not candidates for either coronary artery bypass grafting (CABG) or conventional percutaneous coronary intervention (PCI). This population is heterogeneous and includes patients with diffuse coronary disease, comorbid conditions or multiple previous bypass operations resulting in no remaining suitable conduits. The majority of...

BACKGROUND Early reports indicate that transmyocardial laser revascularization improves symptoms in patients with refractory angina. However, there is little experimental evidence of whether blood flow through channels is the mechanism of action. METHODS Endocardial channels were made in the distribution of the left anterior descending coronary artery in canine hearts (n = 5) using a holmium:...

In the past 35 years many experimental studies have been performed to investigate the revascularization potential of transmyocardial revascularization and the possible working mechanisms underlying the observed clinical improvement in angina pectoris after this treatment. In this review of the experimental literature, the various methods that have been used to create transmyocardial channels an...

Myocardial laser revascularization is a novel therapeutic technique aimed at delivering oxygenated blood via a series of channels to the ischemic regions of the heart. These channels may be created surgically or via a less invasive percutaneous approach. In patients with end-stage coronary artery disease, both transmyocardial laser revascularization (TMR) and percutaneous myocardial laser revas...

Transmyocardial revascularization (TMR) with CO2-laser equipment is an alternative approach in the treatment of patients with severe ischemic cardiac disease. Several studies concerning morphological features after TMR document a strong transmyocardial injury, but little is known about wound healing in laser-induced alterations of the cardiac skeleton and their putative role for angiogenesis an...