My father's cardiologist has recommended that the transmyocardial revascularization procedure might benefit him and relieve some of his severe angina symptoms. We have been accumulating research and information about this procedure and are becoming confused. It appears that the way the procedure is performed has now changed. It is now performed by leg catherization from inside the heart, rather than through a chestwall incision and performed on the outside of the heart. Is this correct? What are the advantages/disadvantages of this new way, other than a little less invasive and shorter recovery time? We have also read that combining TMR with gene (protien) therapy appears to be the most beneficial mode of treatment. Is this true? Where do we get more information/research studies on this combination procedure and where it is being performed? Does insurance cover any of it, especially given my father's condition? He is no longer a candidate for by-pass surgery. He is 74 yrs old, has had 9 by-passes, numerous angioplasties, and 2 stents. He currently has 1 blocked artery which could not be cleared by angioplasty, rotoblater (?), or laser angioplasty. All other arteries look pretty good according to his cardiologist. Other than his heart problems, he is in fairly good shape. Sorry for so many questions, but we are a little confused about what to do next and he is suffering a lot. The technology appears to be changing faster that we can make decisions. We do not seem to get many concrete answers from his cardiologist. He is very good, but a little perplexed about my father's case. We would appreciate any answers to the above questions. Thank you very much!!
There are two approaches to the laser therapy. One involves making a surgical incision and applying the laser to the outside of the heart wall. The other approach is using the laser form the inside with a catheter, much like a cardiac catheterization. Both approaches appear to work in appropriate patients. The surgical approach is approved for use; the catheter approach is experimental. However, the catheter approach is much simpler form the patient
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