Percutaneous Myocardial Revascularization A new procedure offers a new approach for treating angina in patients with
previously untreatable disease. In this procedure, which is still under trial by the FDA, the interventional cardiologist uses a laser catheter to create small channels in the heart wall from within the
heart. The purpose of the channels is to provide blood irrigation to the heart muscle from within the heart.  The Percutaneous Myocardial Revascularization(PMR) procedure,
which takes about two hours, is done in the cardiac catheterization lab using a fiber optic catheter inside a guiding catheter. The cardiologist inserts the guiding catheter through the femoral artery
into the left ventricle. The fiberoptic catheter is then inserted through the guiding catheter, and is then positioned against the interior wall
of the left ventricle in the area suffering from blood starvation (ischemia). Once the fiber optic catheter is in position, the cardiologist activates a holmium laser connected to the fiber optic
catheter to create a small channel. The procedure is repeated, creating enough channels about 1 cm. apart to cover the blood-starved area of the heart muscle.
Although the channels created by this procedure eventually heal and recede, the goal is the creation of new blood vessels. The PMR channels seem to promote the generation of new
blood vessels in the areas around the channels, and this increases internal irrigation of the heart muscle with oxygen-rich blood. It is hoped that these new blood vessels will continue
supplying the needed nutrients and oxygen to the heart muscle for a long-term after the original PMR channels recede.
Although this holmium laser PMR therapy is under FDA investigation, Dr. Ali Massumi of Hall-Garcia Cardiology Associates
was certified in early 1998 to use it on patients with severe heart artery blockage and angina (chest pain), and who are not candidates for stents or bypass surgery. Any patients
who feel they are candidates for the procedure should contact us.
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