Transmyocardial Revascularization (TMR) Cost in South Korea

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\u2019t worked or isn\u2019t 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 \u2014 such as ECG, echocardiography, coronary angiography, and stress tests \u2014 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 CO\u2082 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\u201340 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\u201348 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\u201390% 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.