Stanford's 35 years of experience in coronary artery bypass surgery means patients receive state-of-the-art surgical treatment and care for this mainstay procedure.

Additionally, skills honed over decades have led to the development and refinement of innovative strategies for myocardial revascularization for patients who are not candidates for standard coronary artery bypass surgery.

The specific services available to your patients suffering from coronary artery disease include:

• Minimally invasive coronary artery bypass operations
  
  
• Off-pump coronary artery bypass operations
  Off-pump involves cases when surgery can be performed without use of the cardiopulmonary bypass machine. This option should be discussed with your physician. On-pump refers to the use of the cardiopulmonary bypass machine.
  
  
• Multiple arterial conduit coronary artery bypass graphing
  
  
• Minimally invasive, endoscopic saphenous harvesting
  
  
• Use of anastomotic connectors for coronary artery bypass grafts
  
  
• Laser transmyocardial revascularization or TMR (used when bypass grafts cannot be performed to create a series of channels between the outside and inside of the heart that increase blood supply as treatment for angina).
• Combined myocardial revascularization and mitral valve repair procedures for ischemic mitral regurgitation.
  

Transmyocardial Revascularization (TMR)

In this procedure, a surgeon makes an incision on the left breast to expose the heart. Then, using a laser, the surgeon drills a series of holes from the outside of the heart into the heart's pumping chamber.

How TMR reduces angina still isn't fully understood. The laser may stimulate new blood vessels to grow, called angiogenesis. It may destroy nerve fibers to the heart, making patients unable to feel their chest pain.