TMR - Laser Focus Treatment for Chest Pain

Heart Procedure When Options Are Limited

Coronary heart disease is the most common type of heart disease. About 18.2 million adults age 20 and older have coronary heart disease and about 2 in 10 deaths from this disease happen in adults younger than 65 years old.

But there's a surgical procedure that is making an impact on those numbers. It's called Transmyocardial Revascularization (TMR), a procedure used to relieve angina, or chest pain, which is typically caused by a lack of oxygen and blood flow to the heart.

"This is suited for people who are having chest pains and they don't have any other options," said Dr. David Cable, director of Cardiovascular Surgical Services, OSF HealthCare Saint Anthony Medical Center. "When a person has chest pain we first try to put them on medicines to see if that chest pain will go away. We see if they're a candidate for stents or a candidate for bypass surgery. The vast majority of patients who have this have already had multiple stents done; have maybe had one or two operations for bypass surgery and there just isn't any other alternatives. The medicines are failing them. I've had patients literally who can't walk across the room without getting chest pain."

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The patient is not awake during the TMR procedure. After the surgeon makes a small incision in the patient's left or middle chest, the heart muscle is exposed. The surgeon uses a special carbon dioxide laser to make 20 to 40 tiny channels in the heart muscle. The entire procedure takes about two hours and the patient is expected to stay in the hospital from two to four days.

"TMR uses a laser and it creates holes on the heart and we believe it stimulates new blood vessel growth in that area," said Dr. David Cable, director of Cardiovascular Surgical Services, OSF HealthCare Saint Anthony Medical Center. "We know it's very effective in numbing up the nerves that are there. Most people get a 95 percent success rate with it. It's not 100 percent. Everyone we've had has improved though. That's the big difference. We've had some people doing things now they couldn't do before."

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Dr. David Cable Laser

That includes Chris Loken, a Rockford-area patient, who was diagnosed with coronary heart disease five years ago and had double bypass surgery. But in 2019 she began experiencing chest pain again. Dr. Cable performed TMR and now Chris is feeling better, and back to volunteering at a local equestrian center, where's she's helped for the past six years.

"I've rescued horses in the past and had several horses and started volunteering with the little kids and I love it," said Chris Loken, a TMR patient. "It's the most magnificent feeling you can have when you're working with little kids that have disabilities and the horses are sweethearts. It just puts a smile on your face. You leave here happy."