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Transmyocardial Revascularization (TMR) is performed to relieve severe, chronic chest pain (angina) in patients who are not candidates for conventional procedures like angioplasty or coronary artery bypass grafting (CABG). It improves blood flow directly to the heart muscle by creating small channels in the myocardium (heart wall), allowing oxygen-rich blood from the left ventricle to nourish ischemic areas. TMR is especially useful in patients with diffuse coronary artery disease or those with previously failed revascularization attempts.
You should consult a cardiologist if you're experiencing persistent chest pain despite optimal medical therapy, especially if previous stent placement or bypass surgery hasn’t worked or isn’t an option. TMR is typically considered for patients with refractory angina who are at high surgical risk or have complex blockages not amenable to traditional methods.
Preparation for TMR includes a complete cardiac evaluation — such as ECG, echocardiography, coronary angiography, and stress tests — to assess heart function and identify suitable candidates. Patients are advised to fast for several hours before the surgery or procedure and to temporarily stop certain medications as instructed. A detailed consultation will cover the procedure, potential risks, and recovery expectations.
Usually, a powerful CO₂ or Holmium:YAG laser is used for TMR as a minimally invasive treatment or during open heart surgery:
- Hybrid or standalone surgical TMR: After making a tiny incision in the chest, 20–40 tiny channels are formed in the left ventricle wall using a laser. These channels permit blood to enter oxygen-depleted cardiac tissue straight from the ventricle.
- A hybrid strategy: In some situations, if only some coronary arteries can be bypassed and others need TMR, TMR and CABG are combined.
The procedure generally takes one to two hours. Hospitalisation typically lasts 3 to 5 days after standalone TMR, while hybrid TMR with bypass surgery may require a longer stay depending on patient condition and surgical complexity.
- Irregular heart rhythms (arrhythmias)
- Bleeding
- Infection
- Pericardial effusion (fluid around the heart)
- Stroke or heart attack (rare)
- Reaction to anesthesia
- Significant reduction in angina symptoms
- Improved quality of life and exercise tolerance
- Decreased dependence on anti-anginal medications
- Beneficial for patients with no other surgical options
- May promote long-term blood vessel formation (angiogenesis)
Recovery time varies by the type of procedure. After TMR, patients are typically monitored in the ICU for 24–48 hours. Discomfort at the incision site is normal. Physical activity is gradually resumed over weeks. Regular follow-up is essential to monitor heart function and adjust medications.
TMR has an 80–90% success rate in easing the symptoms of angina. Many patients report significant pain reduction and increased everyday functioning, even if it might not be able to treat coronary artery disease. The greatest long-term advantages occur when lifestyle changes and the best medical care are combined.
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Indraprastha Apollo Hospital
Delhi, India
4.4 ( 5 Reviews )
Indraprastha Apollo Hospital is known for delivering treatment to over 200,000 patients every year; 10,000 of which are generally medical tourists. The efficient team of doctors has the record of 99.6 percent success rate. Indraprastha Apollo Hospital deals in treatment of over 50 specialities.
Let’s see some of the features of the infrastructure:
- Spread over 15 acres, the hospital has 710 beds.
- 6 beds dedicated to bone marrow transplant units with very strict infection control practices.
- 64-Slice Scan coupled with data acquisition which provides highest temporal resolution
- One of the hospitals to be using Da Vinci Robotics Surgery System
- In South Asia, the Spect-CT and Pet-CT got their first installation at Indraprastha Apollo Hospital in India
- Technologies such as PET- MR, BrainLab Navigation System, PET-CT, Portable CT Scanner, Tilting MRI, NovalisTx, Cobalt based HDR Brachytherapy, Hyperbaric Chamber, DSA Lab, Fibroscan, 3 Tesla MRI, Endosonography, 128 Slice CT scanner are all installed at the hospital.
- The Cancer Institute at Indraprastha Apollo is equipped with a highly advanced Radiation Oncology Center with ClinaciX, NovalisTx, and HDR-Brachytherapy.
- It is equipped with the largest Sleep Lab in Asia, & has one of the largest Dialysis Units in India.
- A large number of ICU beds than any other Private Hospitals in India.
- WIFI is accessible across the whole campus.
Aakash Healthcare Super Speciality Hospital
Delhi, India
Aakash Healthcare Super Speciality Hospital located in New Delhi, India is accredited by NABH. Also listed below are some of the most prominent infrastructural details:
- One of the biggest tertiary care hospitals in India
- Facility is fusion of state of the art technology, competent clinicians, and world-class infrastructure
- 230 beds
- 70 bedded medical and surgical and Critical Care Unit
- Ward Bed Options- Twin, Deluxe, Sharing and Economy
- Pneumatic Tube System
- Ambulance Services 24x7
- 15 Bedded dialysis unit
- Advanced Neonatal ICU
- Advanced imaging services, including magnetic resonance imaging, computed tomography scanning, digital mammography, ultrasound
- 8 modular OTs
- Flat Panel Cath Labs
- LASIK - SMILE Suite
- Wellness Lounge
- State-of-the-art diagnostic equipment
- 15 Dialysis beds
- 24x7 ‘Trauma & Emergency Center
- Dedicated blood bank
- 24x7 comprehensive patient care.
- Deployed high-end technologies & smart digital system
- Robust Hospital Information Systems to meet complex medical needs of patients
- Robotic assisted surgeries
- International Patients Lounge
- Airport Pick-up and Drop
- Accommodation and Food for Attendant
- Language Interpreter Services
- 4 triage beds, a dedicated sample collection room, 6 observation beds, and highly skilled emergency staff
- Robotic knee replacement surgery
- ATM
- Lounge for visitors
- Internet Access: The whole facility is Wi-Fi enabled
- Travel Desk: Provides an all-round patient care.
- 24x7 pharmacy
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