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Transmyocardial laser revascularization(TMLR) is a new cardiac surgery for whom percutaneous coronary intervention and coronary artery bypass grafting cannot be carried out. This method can operate without a heart-lung machine and it can easily recover without any special equipment of IABP. We have had a clinical application of 55-year-old man with a severe anginal attack. This method was performed on 21 November 1985 and this case was the first successful clinical case in the world. On the other hand, laser vascular anastomosis with CO2 can easily be done with optimal adaptations at the site of the anastomosis. This is a low power laser( 6-12 sec/mm) for vascular anastomosis, These clinical applications were used for severe renal failure with laser vascular anastomosis. The first clinical application was performed for a 44-year-old female patient on 21 February 1985 for shunt operation of hemodialysis. This is the first successful clinical case in the world. For those patients, we have had performed in 111 patients with laser vascular anastomosis, angina pectoris, or chronic renal failure and peripheral vascular disorders.