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What is TMR?


What is Transmyocardial Revascularization?

Chronic chest pain can drastically limit your participation in many of life’s daily activities. Until recently, many patients thought medicines, stints, and bypasses were all that could be done for their angina. Now physicians are using an innovative procedure called Transmyocardial Revascularization or “TMR” to reduce chest pain.

Take Angina On with TMR

Unfortunately, ischemic heart disease may occur in areas that cannot be bypassed. 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.

Support Material

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


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