What is TMR?

What is Transmyocardial Revascularization

Transmyocardial Revascularization (TMR) is a treatment for chronic angina to help reduce or eliminate chest pain by increasing blood flow to blood deprived areas of the heart muscle. The procedure takes place while the patient is under general anesthesia. When TMR is used as a sole therapy, the surgeon can access the heart through a small incision between the ribs. Using a precise, low powered laser, about 20-40 small 1mm channels are created in the target area of the heart muscle which stimulate new blood vessels to form.1

TMR and Bypass Surgery

Unfortunately, ischemic heart disease may occur in areas that cannot bebypassed. During bypass surgery, a surgeon can use TMR on those areas of the heart that cannot be bypassed to more fully improve blood flow to the heart.

The Procedure

If performed as a sole therapy, the surgeon may access the heart through a small incision in the ribs. If he or she is performing robotically assisted TMR, the heart may be accessed through four small ports in the side of the rib cage. TMR may also be performed in open surgical procedures in conjunction with coronary artery bypass grafting (CABG) in areas that cannot be bypassed.

To perform TMR, once the surgeon has assessed the heart, the surgeon places the CardioGenesis fiberoptic handpiece on the beating heart, and delivers 4-6 precise bursts of Holmium:YAG laser energy to create channels in ischemic areas of the heart muscle. Typically 20-40 channels are created. These new channels close almost immediately and research has shown that these channels promote new blood vessel growth over time.

Total operating time for sole therapy TMR is approximately 60 to 90 minutes.


  1. Atluri P, et al. J Thorac Cardiovasc Surg 2008; 135:283-91

Support Material

Support Material

This brochure provides a brief overview of TMR which can be shared with patients and physicians to help explain Transmyocardial Revascularization.


Patient Stories

Hear testimonials from TMR patients as they recount their stories of TMR with how their lives were before and after the procedure.


Coronary Artery Bypass Grafts and TMR

Combine coronary artery bypass surgery with TMR to revascularize additional areas of the heart and help maximize patient outcomes.