Lasers in the treatment of ischaemic heart disease

Mounting evidence showing that transmyocardial laser revascularization (TMR ) is a safe and effective treatment for angina pectoris arrives just as an increasing number of patients who have undergone angioplasty and coronary a rtery bypass grafting experience failure with time. TMR, nevertheless, rema ins controversial, It appears to relieve the symptoms without treating the underlying atherosclerotic disease, and its method of action is unproven. L ike angioplasty and coronary bypass, TMR in fact offers palliation rather t han a cure for atherosclerotic heart disease. The most sensible current for mulations of the therapeutic mechanism of TMR posit a reconfiguration of th e microcirculation, with blood shunted from epicardial to endocardial areas , These unresolved issues notwithstanding, TMR benefits patients with end-s tage coronary disease and represents a pioneering effort to remodel the mic rocirculation of patients with arteriosclerotic occlusive disease.