The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on transmyocardial laser revascularisation for refractory angina pectoris. Full guidance has also been published on percutaneous laser revascularistion for refractory angina pectoris (NICE interventional procedure guidance 302, May 2009).


Patients with refractory angina pectoris have chest pain (because of insufficient oxygen delivery to their heart muscle) that cannot be controlled by optimal medical or surgical management. Transmyocardial laser revascularisation involves open heart surgery to drill holes on the heart muscle using a laser beam, with the aim of enabling blood flow from the heart chambers into the heart muscle, to relieve myocardial ischaemia and reduce chest pain.

Coding recommendations

K23.4 Revascularisation of wall of heart

Includes: Revascularisation of heart

Y08.5 Laser modification of organ NOC

Note: U20.2 Transoesophageal echocardiography is also assigned when transoesophageal echocardiography (TOE) is used during the procedure.

In addition a code from category I20.- Angina pectoris is assigned.

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