Coronary sinus reductor – a novel approach in “no-option” patients

Despite the progress that has been made in the treatment of coronary heart disease, there is still a group of patients (approx. 2–3%) whose angina symptoms persist in spite of an optimal therapy (refractory angina, no-option angina). The concept of increasing blood flow to the ischaemic myocardium t...

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Autores principales:	Piotr M. Wańczura, Wojciech Stecko, Andrzej Curzytek, Wojciech Wojakowski
Formato:	article
Lenguaje:	EN
Publicado:	Termedia Publishing House 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/a71f09328b5e4e5ea24341d9190bc603
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spelling	oai:doaj.org-article:a71f09328b5e4e5ea24341d9190bc6032021-12-02T17:46:06ZCoronary sinus reductor – a novel approach in “no-option” patients1734-93381897-429510.5114/aic.2021.107514https://doaj.org/article/a71f09328b5e4e5ea24341d9190bc6032021-07-01T00:00:00Zhttps://www.termedia.pl/Coronary-sinus-reductor-a-novel-approach-in-no-option-patients,35,44606,1,1.htmlhttps://doaj.org/toc/1734-9338https://doaj.org/toc/1897-4295Despite the progress that has been made in the treatment of coronary heart disease, there is still a group of patients (approx. 2–3%) whose angina symptoms persist in spite of an optimal therapy (refractory angina, no-option angina). The concept of increasing blood flow to the ischaemic myocardium through revascularization procedures (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)) is the gold standard of the treatment. The development of cardiosurgical methods and percutaneous recanalization techniques, as well as the extension of standard pharmacotherapy, allowed a further reduction of symptoms only in some patients. For those symptomatic patients a coronary sinus flow reducer may be a solution [1]. The essence of its action assumes that the obstruction of the blood outflow from the coronary sinus causes an increase in pressure in the venous part of the coronary circulation and in the microcirculation, and facilitates the delivery of oxygen to myocardial cells. An indication for an implantation of the reducer is refractory angina, defined as the persistence of symptoms for more than 3 months despite the combination of pharmacotherapy, angioplasty, and CABG (class II b). These criteria were met by a 70-year-old patient with obesity (BMI = 45.66 kg/m2), hypertension, hyperlipidaemia, type 2 diabetes, after a stroke, CABG, multiple PCI, and pacemaker implantation. The patient was made to use nitroglycerin up to 20 times a day in the period preceding the treatment. Due to the exhaustion of therapeutic options (no possibility of further revascularization of the coronary arteries), the patient was qualified for implantation of a sinus-coronary flow reducer.Piotr M. WańczuraWojciech SteckoAndrzej CurzytekWojciech WojakowskiTermedia Publishing HousearticleMedicineRENAdvances in Interventional Cardiology, Vol 17, Iss 2, Pp 242-243 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Piotr M. Wańczura Wojciech Stecko Andrzej Curzytek Wojciech Wojakowski Coronary sinus reductor – a novel approach in “no-option” patients
description	Despite the progress that has been made in the treatment of coronary heart disease, there is still a group of patients (approx. 2–3%) whose angina symptoms persist in spite of an optimal therapy (refractory angina, no-option angina). The concept of increasing blood flow to the ischaemic myocardium through revascularization procedures (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)) is the gold standard of the treatment. The development of cardiosurgical methods and percutaneous recanalization techniques, as well as the extension of standard pharmacotherapy, allowed a further reduction of symptoms only in some patients. For those symptomatic patients a coronary sinus flow reducer may be a solution [1]. The essence of its action assumes that the obstruction of the blood outflow from the coronary sinus causes an increase in pressure in the venous part of the coronary circulation and in the microcirculation, and facilitates the delivery of oxygen to myocardial cells. An indication for an implantation of the reducer is refractory angina, defined as the persistence of symptoms for more than 3 months despite the combination of pharmacotherapy, angioplasty, and CABG (class II b). These criteria were met by a 70-year-old patient with obesity (BMI = 45.66 kg/m2), hypertension, hyperlipidaemia, type 2 diabetes, after a stroke, CABG, multiple PCI, and pacemaker implantation. The patient was made to use nitroglycerin up to 20 times a day in the period preceding the treatment. Due to the exhaustion of therapeutic options (no possibility of further revascularization of the coronary arteries), the patient was qualified for implantation of a sinus-coronary flow reducer.
format	article
author	Piotr M. Wańczura Wojciech Stecko Andrzej Curzytek Wojciech Wojakowski
author_facet	Piotr M. Wańczura Wojciech Stecko Andrzej Curzytek Wojciech Wojakowski
author_sort	Piotr M. Wańczura
title	Coronary sinus reductor – a novel approach in “no-option” patients
title_short	Coronary sinus reductor – a novel approach in “no-option” patients
title_full	Coronary sinus reductor – a novel approach in “no-option” patients
title_fullStr	Coronary sinus reductor – a novel approach in “no-option” patients
title_full_unstemmed	Coronary sinus reductor – a novel approach in “no-option” patients
title_sort	coronary sinus reductor – a novel approach in “no-option” patients
publisher	Termedia Publishing House
publishDate	2021
url	https://doaj.org/article/a71f09328b5e4e5ea24341d9190bc603
work_keys_str_mv	AT piotrmwanczura coronarysinusreductoranovelapproachinnooptionpatients AT wojciechstecko coronarysinusreductoranovelapproachinnooptionpatients AT andrzejcurzytek coronarysinusreductoranovelapproachinnooptionpatients AT wojciechwojakowski coronarysinusreductoranovelapproachinnooptionpatients
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Coronary sinus reductor – a novel approach in “no-option” patients

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