TMR March 1, 2001 Mary Ellen Foltz Medical Policy Highmark/Pennsylvania Blue Shield Dear Mrs. Foltz: In response to your February 16, 2001, correspondence regarding the status of transmyocardial laser revascularization (TMR), I have solicited the opinion of Dr. Marco Zenati of the Division of Cardiovascular Surgery at The University of Pittsburgh Medical Center. The American College of Cardiology currently does not have an official position on TMR. This issue was previously discussed in a March 18, 1999 letter from Dr. Zenati, which was subsequently forwarded to you. I have spoken with Dr. Zenati today and he informs me that since his previous correspondence there has been no substantive additional data regarding TMR. As such, his thoughts from the March 1999 correspondence should stand as being current. I hope this information is of some help to you. Please let me know if I can provide you with any additional information. Sincerely, James P. MacKrell, M.D., FACC JPM/mrm C: Louis Borgatta, M.D. Alan H. Gradman, M.D. James G. Kitchen, III, M.D. Joseph G. Cacchione, M.D.