ISSN: 2155-9880
+44 1300 500008
Marco Piciche
San Bortolo Hospital, Italy
Keynote: J Clin Exp Cardiolog
No one knows the true incidence of refractory angina, but it is generally agreed that there are thousands new cases annually.
The incidence will presumably increase with the increase of average age. Patients suffering from refractory angina are known
as no-option, because they are not amenable to coronary artery bypass grafting or percutaneous coronary interventions. The main
reason to be unamenable to conventional revascularization techniques is a diffuse coronary disease, and secondarily comorbidities.
Several alternative methods have been advocated, such as stem cell therapy, external counter-pulsation, laser transmyocardial
revascularization sympathectomy, partial occlusion of the coronary sinus, shock wave myocardial revascularization. The internal
mammary artery (IMAs) has the potential for developing collateral branches under some circumstances. This was the basis for an
old operation performed in the 1940s, i.e. the tunnellization of the IMAs in to the left ventricle free wall.
Recent Publications
1. Iwanski J, Knapp S M, Avery R, Oliva I, Wong R K, Runyan R B, et al. (2017) Clinical outcomes meta-analysis:
measuring subendocardial perfusion and efficacy of transmyocardial laser revascularization with nuclear imaging.
Journal of Cardiothoracic Surgery 12(1):37.
2. Holland L C, Navaratnarajah M and Taggart D P (2016) Does surgical sympathectomy improve clinical outcomes in
patients with refractory angina pectoris? Interactive Cardiovascular and Thoracic Surgery 22(4):488-92.
3. Giannini F, Baldetti L, Ielasi A, Ruparelia N, Ponticelli F, Latib A, et al. (2017) First Experience with the coronary sinus
reducer system for the management of refractory angina in patients without obstructive coronary artery disease. JACC:
Cardiovascular Interventions 10(18):1901-1903.
4. Myojo M, Ando J, Uehara M, Daimon M, Watanabe M and Komuro I (2017) Feasibility of extracorporeal shock wave
myocardial revascularization therapy for post-acute myocardial infarction patients and refractory angina pectoris
patients. International Heart Journal 58(2):185-190.
5. Picich�¨ M (2012) The history of myocardial revascularization before the advent of cardiopulmonary bypass. Dawn and
Evolution of Cardiac Procedures 65�77, ISBN: 978-88-470-2400-7.