NEWARK, N.J. -- Last year, Newark
Beth Israel Medical Center became the first hospital
in New Jersey to offer the first Food and Drug
Administration (FDA)-approved technique to perform
Transmyocardial Revascularization (TMR). The new
treatment is an alternative for people with severe
coronary artery disease that is not treatable by
conventional techniques such as bypass surgery
and angioplasty. Cardiac surgeons at Newark Beth
Israel are using new technology called The Heart
Laser System, which is the first clinically proven
TMR product to receive FDA approval in the U.S.
It is estimated that 80,000 Americans are diagnosed
each year with severe coronary artery disease,
which is not treatable by conventional revascularization
techniques. Coronary artery disease is a form of
heart disease caused by blockage of blood flow
into the coronary arteries, which supply oxygen-rich
blood to the heart muscle. It can lead to heart
attack and is the major cause of death in the U.S.
About 500,000 Americans die from coronary artery
disease each year.
"The typical TMR candidate has run out of options," said Craig
R. Saunders, M.D., Chairman of Cardiothoracic Surgery for the
Saint Barnabas Health Care System. "He or she is immobilized by
chest pain, shortness of breath and fatigue. Traditional surgery
is not feasible and a daily, heavy dose of drug therapy is not
enough. TMR is a chance for a better life.
In TMR, a high-energy, carbon dioxide (CO2) laser places channels
through oxygen-deprived heart muscle into the heart's left ventricle.
Clinical studies have shown that the creation of these channels
allows oxygen-rich blood to flow into the heart muscle again,
despite blocked arteries. TMR is performed on a beating heart,
generally through a small left chest incision. It usually does
not necessitate a blood transfusion, and because it is performed
on a beating heart, does not require the use of a heart-lung machine.
According to Dr. Saunders, in some cases combining TMR with bypass
surgery is highly effective since TMR can be used in areas of
the heart where bypasses cannot be performed.
Other hospitals are currently involved in research protocols
to test a non-surgical revascularization system that uses catheter-based
lasers, however, this approach has not received FDA approval.
The surgical technique now in use at Newark Beth Israel provides
significantly more opportunity for angiogenesis because it provides
direct access to the heart, and therefore allows the surgeon to
create many more channels than if a catheter-based laser was used.
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