Fig. 1

Transmyocardial revascularization (TMR). TMR is performed on the heart by lasing channels in the myocardium, with an energy output of 7 W per laser pulse using the Ho:YAG fiber optic hand tool. The grey region seen on the heart represents an infarcted zone following ischemic damage. Depending on the ischemic region and size of the patient heart, a total of 20–40 channels are created using the TMR laser hand piece. Typically, channels are placed on the antero-lateral, apical, and infero-apical regions of the heart