JHMI Office of Communications and Public Affairs

Creating Channels Inside The Heart Could Bring Hope To People With Severe Chest Pain

January 26, 1998
Media Contact: Karen Infeld
Phone: (410) 955-1534
E-mail: kinfeld@welchlink.welch.jhu.edu

Heart specialists at Johns Hopkins are testing laser surgery to relieve severe angina, or suffocating chest pain.

Called percutaneous myocardial revascularization (PMR), the procedure uses a holmium-yttrium-aluminum-garnet (Ho:YAG) laser to make tiny channels in the heart muscle from within the heart. The laser is threaded through tubes inserted in the leg until it touches the heart wall. Patients are awake during the procedure.

PMR is less invasive than a similar laser procedure, transmyocardial revascularization (TMR), in which patients get general anesthesia and the laser is inserted through an incision in the chest to make the tiny holes.

"It is believed that making these channels relieves symptoms by improving blood flow to oxygen-starved regions of the heart muscle," says Jon R. Resar, M.D., principal investigator for the trial and an assistant professor of medicine. "Very early results suggest that within months, the channels may promote the growth of new blood vessels in those regions."

Resar is accepting up to 30 patients for the Hopkins study, people suffering terrible chest pain with or without physical activity. Subjects must be on maximum medication and ineligible for balloon angioplasty or other surgical procedures.

During the procedure, physicians inject a small amount of dye into the heart's blood vessels to locate them. The vessels serve as landmarks during PMR. Physicians also inject dye into the left pumping chamber of the heart to locate the walls. This guides them as to where to make the tiny holes. They then thread the laser up through the patient's leg to the heart.

Patients may require up to 20 channels. They do not feel anything when the laser is fired.

For more information or to volunteer for the study, call Kathleen Citro, R.N., B.S.N., at 410-955-7377.

The clinical trial is sponsored by CardioGenesis Corp. of Sunnyvale, Calif., manufacturers of the laser.

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