Efficacy and outcome of transmyocardial revascularization [TMR]: initial egyptian experience

In this study, 37 patients [with age 52 +/- 10.1, 31 males and 6 females] with severe coronary artery disease [CAD] and intractable angina were subjected to TMR. Nineteen patients had prior myocardial infarction [MI]. The mean angina class was 3.4 +/- 0.5. All patients were subjected to stress-redistribution reinjection [ST-RD-RI] Thallium SPECT protocol and rest 99 mTc-RBG MUGA just before, 3, 6, 9 and 12 months after TMR, aiming to assess the degree of change in perfusion in the ischemic area using semiquantitative score [I = normal and 4 = absent uptake] and to assess the function. The study concluded that TMR can be used effectively in cases of severe CAD, which could not be managed by either CABG or PTCA. Myocardial perfusion imaging is a good method to assess TMR results

Transmyocardial revascularization [TMR] versus medical treatment in patients with exensive coronary artery disease [12 months follow-up]

The aim of this study was to compare the efficacy of TMR versus medical management in cases of severe CAD not amenable to percutaneous transluminal coronary angioplasty [PTCA] or coronary artery bypass grafting [CABG]. Sixty-six patients with severe CAD were treated randomly, either by TMR or medical treatment. Accordingly, they were divided into two groups: Group 1 included 26 patients who were treated medically, while group 2 included 40 patients who were treated by TMR. All patients were subjected to clinical assessment and stress-redistribution-reinjection [ST-KD-RI] Thallium SPECT protocol pre and post TMR [3, 6, 9 and 12 months]. The study concluded that TMR has been proved to be effective in the management of severe cases of CAD concerning the quality of life and survival. Transmyocardial revascularization is a treatment option for patients with medically refractory angina who are not candidates for conventional revascularization