Transmyocardial laser revascularization (TMLR) involves the use of a laser to create tiny channels in the lower left chamber of the heart (the left ventricle), which may increase blood flow within the heart. Surgeons make an incision in the left side of the chest. While the heart is still beating, the surgeons use the laser to make between 20 and 40 tiny (one-millimeter-wide) channels through the oxygen-deprived heart muscle and into the left ventricle. These channels give a new route for blood to flow into the heart muscle, which may reduce the pain of angina. TMLR is generally considered less invasive than open heart procedures. It involves only a small incision, and patients usually do not need a blood transfusion. And because the procedure is done on a beating heart, surgeons do not need to use a heart-lung machine. Although the procedure has been approved by the Food and Drug Administration, TMLR is only being used on patients who have not responded to other treatments such as medicines, angioplasty, or coronary artery bypass surgery.http://www.texasheart.org/HIC/Topics/Cond/CoronaryArteryDisease.cfm
