HEART AND LUNG SURGERY << BACK Transmyocardial Revascularization (TMR) Transmyocardial revascularization, (TMR) is a relatively new procedure used to treat inoperable heart disease in people with persistent angina. TMR uses a special carbon dioxide laser to create small channels in the heart muscle, improving blood flow. TMR is done through a small incision in the chest. Sometimes it is done along with coronary artery bypass surgery, but can be done alone. TMR is a treatment option for individuals who have angina severe enough to limit their daily activities or to awaken them at night, and who have a history of previous bypass surgery or angioplasty. It is recommended for patients for whom no other intervention is available, or who have been told there is nothing further that can be done to relieve their symptoms. It is often recommended for diabetic patients who have areas of the heart that can't be bypassed using traditional methods. Patients undergoing TMR may expect to stay in the hospital four to seven days. After TMR, patients may still be required to take medications to help improve blood flow to the heart. Usually, you will be referred to the Providence cardiac rehabilitation program or to the cardiac rehabilitation program in your hometown to enhance recovery and improve activity level after surgery.