Keyhole" is the buzzword for lasers in cardiovascular surgery, as it is in many other surgical disciplines. Minimally invasive procedures are being cultivated to reduce the injury and healing time for patients, and reduce the cost for insurance companies. Though techniques such as transmyocardial revascularization (TMR) are in their infancy and the road ahead is admittedly long, lasers could serve a large pool of patients who suffer from cardiovascular disease and the pain associated with it. TMR is the hot topic in cardiology, according to Peter Whittaker of the Heart Institute at Good Samaritan Hospital in Los Angeles. The technique replaces bypass surgery or balloon angioplasty for an increasing number of patients who are not good candidates for those older procedures. It employs laser energy, most commonly from a CO2 or Ho:YAG laser, to drill channels in the heart, allowing blood to flow to blood-starved areas of heart tissue.