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Professional Society Practice Guidelines
Despite multiple randomized controlled trials showing safety and efficacy, society guidelines have changed overtime. This is possibly due to confusion with Direct Myocardial Revascularization (DMR), which was a different procedure1.
Year | Recommendations | Evidence Rating |
---|---|---|
2003 | ACC/AHA Guideline for Management of Patients with Chronic Stable Angina2 | |
Surgical TMR as alternative therapy for chronic stable angina in patients:
|
Class IIa, Level A | |
2004 | STS Practice Guideline for Transmyocardial Laser Revascularization3 | |
TMR sole therapy for patients with:
TMR adjunctive to CABG for patients with:
|
Class I, Level A
Class IIa, Level B |
|
2006 | ISMICS Consensus Statement for Transmyocardial Laser Revascularization4 | |
TMR sole therapy for stable patients with refractory severe angina not amenable to conventional revascularization, to:
TMR adjunctive to CABG for patients with diffuse CAD who cannot be completely revascularized by CABG alone, to:
|
Class I, Level A
Class I, Level A Class IIa, Level B
Class IIa, Level B Class IIa, Level A/B |
|
2011 | ACC/AHA Guideline Update for Coronary Artery Bypass Graft Surgery5 | |
Surgical TMR, either alone or in combination with CABG, is reasonable in patients:
|
Class IIb, Level A | |
2012 | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease6 | |
|
Class IIb, Level A
Class IIb, Level B |
References
- Leon, M. et al. , J Am Coll Cardiol. 2005 Nov 15;46(10):1812-9. Epub 2005 Oct 19.
- Gibbons RJ, et al. Circulation 2003;107:00-00.
- Bridges CR, et al. Ann of Thorac Surg 2004;77:1494-1502.
- Diegeler A, et al. Innovations 2006;1:314-322.
- Hillis LD, et al. Circulation 2011;124:2610-2642
- Fihn, SD, et al. Circulation. 2012; 126(25): e354-347
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