Re: The benefits of TMR?

Posted By Don on July 05, 1999 at 11:00:17
I've been researching TMR (Transmyocardial Revascularization) for several years now, and i am wondering if it is a benefit for the overall improvement of the heart function itself.
From what i can obtain from all the research, TMR when provided is suppose to relieve the angina from patients who have no other options for conventional revascularization (Angioplasty, Stent Placements, CABG).
My question is, "Angina" is suppose to be a warning to the body that the heart is not able to administer enough blood-flow to the needed area, in order to keep up with the amount of exersion being put on the heart. If by creating these channels with the laser, allows only the releif of angina (or lowers the class of angina), wouldn't that be like removing the "Stop-Signs" from a 4 way intersection? My point being, the danger of overloading the heart will still be there, but the warning signs (Angina) will have been removed, leaving the patient in a dangerous situation of not knowing when to slow down or stop.
It is also my understanding that the channels drilled during the TMR (laser) have not proved to remain open for any length of time, and also leaving behind a degree of scar tissue.
The addition of the gene (VEGF) "Angiogensis" therapy injection along with the laser (TMR) seems to be the direction of medical science, but to date i can't find any conclusive results on these trials. I have read that a concern has been raised about the fear of the gene therapy having some affect on the eyes (retna), or is suspect of this.
I'm not sure if i'm on target here with these questions or comments, but i felt the need to inquire about these.
I myself have became unavailible (no option) for another CABG, due to complete arterial defusion of the graphs from my previuos CABG (X-6) in 1988, leaving only the "LIMA" (Mammary) left open for blood supply. All of the other graphs are occluded completely, and i now have to find an alternitive for this problem.
I probably won't be able to find this board again, so if anyone out there can answer some or all of these questions, please email me at:
***@****
Best Wishes to everyone, and Good Health,
Don........RANGERDOOD

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on July 06, 1999 at 12:08:18
Dear Don
It is true that the channels created by PMR do not stay open for too long. The prevailing hypothesis is that the laser stimulates new blood vessel growth. Thus, it is believed that PMR actually improves blood flow to the heart, but does not just get rid of the symptoms, which as you point out can serve as a warning. Potentially PMR could get rid of pain by destroying nerve endings, and this would compromise the body's warning system. I agree that direct injection of growth factors may be promising, but it will be a while before there is considerable experience with this technique. A concern with growth factors is that they may cause growth of new blood vessels in undesirable locations, such as the eye and tumors.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Tom-Riedman]

Posted By Tom Riedman on July 19, 1999 at 21:25:28
Dear Don,
Have you heard of EECP, the noninvasive outpatient treatment for chronic stable angina pectoris? I work as a clinician for EECP and have seen many patients similar to your cardiac history be treated with good results, less angina and improved quality of life. Please visit www.EECP.com to learn more. Ask your cardiologist. It is being used at some of the top cardiology centers(except Cleveland Clinic so far) across the country. Good luck










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Re: The benefits of TMR? CCF CARDIO MD - DLB 7/22/1999
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