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Heart Disease (Expert Forum)
Regarding Transmyocardial revascularization
Answered by
Cleveland - OH
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Regarding Transmyocardial revascularization
by meghaprakash, Mar 30, 2004 12:00AM
Dear,
My dad was admitted in the hospital for Angiogram(CAG in medical term),to diagnoise the problem since he had symptoms like chest pain.We consulted the Dr who confirmed the mild-attacks after the examination and adviced to take CAG for detailed study on the disease.During CAG, he went into "Acute Pulmonary Oedema" (Breathless due to liquid formation in Lungs, Could be developed
stress during the procedure) requiring ventilatory support.
CAG revealed Triple vessel disease, fair L V function, he was stabilized & subsequently weaned off the ventilator the following day. he has been discharged in a stable condition on a list of some medications. Currently the doctors suggested not to go for ByPass surgery as well as AngioBlast since it proved risky in my dad's case at his age of 60 and suffering from diabetics.
The doctors also confirmed that he is suffering from "Triple Vessel Disease" (all three vessels have diffused occlusion (block) through out the path ) the Bypass wont produce good result.
If there is one or two blocks they can bypass that block thru someother vein. In his case, there is no place to bypass
They prescribed "Medication" for good result than a Bypass Surgery. But, we are always on the risky side.
Recently, we have come to know that there is a Laser treatment called Transmyocardial revascularization, or TMR. Is it possible for my dad to go through this treatment ? If yes can you please tell me the details of TMR ? Can you please get bact to me details. Looking forward for the help. Thanks a lot.
Regards,
Prakash
My dad was admitted in the hospital for Angiogram(CAG in medical term),to diagnoise the problem since he had symptoms like chest pain.We consulted the Dr who confirmed the mild-attacks after the examination and adviced to take CAG for detailed study on the disease.During CAG, he went into "Acute Pulmonary Oedema" (Breathless due to liquid formation in Lungs, Could be developed
stress during the procedure) requiring ventilatory support.
CAG revealed Triple vessel disease, fair L V function, he was stabilized & subsequently weaned off the ventilator the following day. he has been discharged in a stable condition on a list of some medications. Currently the doctors suggested not to go for ByPass surgery as well as AngioBlast since it proved risky in my dad's case at his age of 60 and suffering from diabetics.
The doctors also confirmed that he is suffering from "Triple Vessel Disease" (all three vessels have diffused occlusion (block) through out the path ) the Bypass wont produce good result.
If there is one or two blocks they can bypass that block thru someother vein. In his case, there is no place to bypass
They prescribed "Medication" for good result than a Bypass Surgery. But, we are always on the risky side.
Recently, we have come to know that there is a Laser treatment called Transmyocardial revascularization, or TMR. Is it possible for my dad to go through this treatment ? If yes can you please tell me the details of TMR ? Can you please get bact to me details. Looking forward for the help. Thanks a lot.
Regards,
Prakash
Doctor's Answer
by Cleveland Clinic, Mar 30, 2004 12:00AM
, Mar 30, 2004 12:00AM
meghaprakash,
Thank you for your post. First, really the standard of care for a patient with diabetes and 3 vessel coronary disease should be bypass surgery. That said, in some patients this is not an option. Without being able to review your information personally, I would strongly advise a second opinion at a tertiary referral center that does a very large volume of cornary bypass surgeries to ensure that this is not an option.
TMR, really hasn't been shown to have a significant impact on overall outcomes with respect to mortality or improveing ischemia. There is some thought it may be beneficial in patients with refractory angina.
Again, my next step would be a second opinion from the facts you provided.
good luck
Thank you for your post. First, really the standard of care for a patient with diabetes and 3 vessel coronary disease should be bypass surgery. That said, in some patients this is not an option. Without being able to review your information personally, I would strongly advise a second opinion at a tertiary referral center that does a very large volume of cornary bypass surgeries to ensure that this is not an option.
TMR, really hasn't been shown to have a significant impact on overall outcomes with respect to mortality or improveing ischemia. There is some thought it may be beneficial in patients with refractory angina.
Again, my next step would be a second opinion from the facts you provided.
good luck
Could you kindly tell me what exactly is meant by the term
REFRACTORY ANGINA
Thanking you,
Chris R
Thanks for the response for my mail. I have got my dad's medical report.. If you could give me you id or the means ot pass on the report.. I'll pass it on.. so that you can have a detail look on his medical history.
Thanks,
Prakash