What are the indications for TMR? Are there any contra-indications?
The indication is for stable angina (Class 4) refractory to medical treatment and secondary to objectively demonstrated coronary artery atherosclerosis and with a region of the myocardium with reversible ischemia not amenable to direct coronary revascularization. TMR should not be used in those types of defects in the left ventricle with irreversible defects from scar tissue created from prior acute myocardial infarction. Also, there is no clinical data showing efficacy of TMR with patients who have an ejection fraction less than 25%.
