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Laser surgery halts chest pain over the long-term; scientists also looking into non-surgical TMR

In one of the largest studies to date, researchers have shown that transmyocardial revascularization, or TMR - a surgical procedure that uses a laser to drill holes in the heart - can reduce or alleviate angina (chest pain) in a majority of individuals for at least five years, according to research being presented at the American Heart Association's Scientific Sessions 2000.

Meanwhile, another study being presented today may open the door to a non-surgical form of the laser procedure.

TMR uses a carbon dioxide laser to make multiple channels in the heart for blood to flow through. Although no one is sure exactly why or how the procedure helps to reduce chest pain, it has proven to be effective over the short-term. Now the results of a new study indicate that TMR is also effective for longer periods of time. Researchers report that 60 percent of the patients in their study who've undergone TMR have had chest pain relief for at least five years.

"Whatever symptom relief these patients had at one year seems to be holding true out to five years," says Keith Horvath, M.D., lead researcher of the TMR study and assistant professor of cardiovascular surgery, Northwestern University Medical School, Chicago. "We have a significant number of patients who have experienced pain relief for as long as eight to nine years following their TMR surgery."

There are several theories as to why TMR is effective in curbing chest pain. It may be that the laser channels provide a new source of blood to the heart. Another theory is that TMR triggers angiogenesis -- the stimulation of new blood vessel growth. Yet another theory is that nerves in the affected area of the heart are destroyed, numbing the heart and thus relieving chest pain.

Horvath and his colleagues studied 65 patients whose average age was 63. All of them had severe chest pain that was not alleviated through other methods. Sixty-three percent had unstable angina, 75 percent had suffered at l
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Contact: Karen Hunter or Carole Bullock
504-670-4000
American Heart Association
13-Nov-2000


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