Gardener, Grandma and Heart Patient
"My chest hurt so bad, I couldn’t even leave the house, let alone keep up with my grandson. Heart bypass wasn’t an option, so when Dr. Jones showed me how the heart laser could help, I went with it."
Heart Laser Gives Grandma Back Her Bounce
Worsening chest pain was slowing Pat Galloway down and keeping her from doing the things she enjoyed. The Midland woman had angina, and tests showed she needed more oxygen to the lower left side of her heart.
In 2004, triple bypass surgery had improved blood flow to another part of Pat’s heart, and those big, grafted arteries were still doing the job. But this time, that kind of surgery wasn’t going to work. Not only were the blood vessels that served the problem area blocked or partly blocked, they were small and scattered through the heart muscle tissue.
Pat returned to the surgeon who performed her bypass, Robert Jones, M.D., who described a procedure called transmyocardial revascularization, or TMR, which he believed could help Pat’s angina.
Using a carbon dioxide laser, he would make pin-sized channels through the heart wall and into the left chamber. The channels would leak for a minute or so, but then seal up quickly. In a few weeks, new blood vessels could be expected to develop around the areas where the channels had been made, improving blood flow and relieving Pat’s pain.
“This procedure helps people we could not do anything for in the past,” said Dr. Jones, director of the open heart program at MidMichigan Medical Center–Midland. “Repeated studies have shown that TMR can relieve angina and improve survival. We’ve had patients who were handicapped because of chest pain and after TMR were able to go outside their home again, grocery shop and live a normal life.”
To perform TMR at MidMichigan Medical Center–Midland, Dr. Jones used a carbon dioxide laser designed exclusively for the heart. The CO2 Heart Laser 2™ from PLC Medical Systems, Inc., requires just one pulse to penetrate all the way through the muscle wall, where it is stopped by the blood that fills the chamber. This advanced laser also times its pulses with the patient’s heartbeat to help the surgeon hit the right spot. Other lasers designed for general medical use, such as a YAG, require 5 to 10 pulses to make each pin-sized channel, according to Dr. Jones, who has used both types. “The CO2 laser’s single pulse causes less damage to nearby muscle cells,” he explained.
The surgeon can perform TMR by itself or as part of other heart surgery. In the surgery Dr. Jones suggested to Pat, he would create 36 channels about one-half inch apart in her heart during an open procedure that did not require the use of a heart-lung bypass machine.
“When he suggested TMR, I went with it, because I knew I could trust him,” said Pat. “Everybody was so helpful and took the time to explain things to me. When Dr. Jones came into my room to see me the morning of the surgery, I wasn’t even nervous.”
After surgery on a Friday, Pat spent four nights in MidMichigan’s critical care unit for family-focused One Stop Post Op care. “I had the same nurses the whole time, and they got to know me fine,” she recalled. “Once they get to watching you, they can tell by the expression on your face if you are starting to have pain. If you had a different nurse every day that might not happen.” Sunday was Mother’s Day, and her family brought her little grandson in to visit. He took a nap on her bed.
New blood vessels typically take about three months to fully develop after TMR surgery, but Pat reported starting to feel better shortly after she got home and she continued to progress. “Sitting home drove me nuts,” she said. “It’s a relief to be able to go out and be more active.”