Author(s)

Crt Langel¹, Mrak Miha², Nejc Pavsic², Matjaz Bunc^2*

¹Clinical Institute of Radiology, University Medical Center Ljubljana, Zaloska, Ljubljana, Slovenia.
²Clinical Department of Cardiology, University Medical Center Ljubljana, Zaloska, Ljubljana, Slovenia.

Background: Due to the aging population and increased survival of the patients with coronary artery disease, there is an increasing number of patients with debilitating angina refractory to optimal medical treatment who are not candidates for revascularization. In case of low ischemic load, the treatment of stable refractory angina is aimed at symptom reduction. There are several new treatment methods targeting myocardial ischemia available, including coronary sinus flow reducer (CFR) implantation. Case Report: We report a case of a patient suffering from CCS class IV angina despite optimal medical therapy, with further revascualrization options exhausted, who was successfully treated with coronary sinus flow reducer (CFR). Besides technical skill to reach ostium of coronary sinus, the most important technical tip is precise positioning of the CFR. The reduction of angina symptoms started after epithelisation of CFR frame, usually 6 - 7 weeks after implantation. At 6-month follow-up, the patient reported a marked reduction of angina symptoms, with CCS grade improving by three classes (from IV to I). At 10-month follow-up, the sustainment of CCS grade I angina symptoms was reported by the patient. Conclusions: We conclude that CFR can be safely and successfully implanted in patients suffering from refractory angina. Considerable improvements in CCS grade may be experienced in certain cases.

Chest Pain, Refractory Angina Pectoris, Myocardial Ischemia, Coronary Sinus Flow Reducer, Chronic Total Occlusion

Langel, C. , Miha, M. , Pavsic, N. and Bunc, M. (2019) Improved Angina Symptoms Following Coronary Sinus Flow Reducer Implantation in a Patient with Refractory Angina and Chronic Total Occlusion: A Case Report. International Journal of Clinical Medicine, 10, 604-612. doi: 10.4236/ijcm.2019.1011049.