What is Angina?
Angina pectoris is defined as a chest pain, pressure, or discomfort that is typically worsened by exertion and/or anxiety or other emotional or mental stress, and lasts more than 30 to 60 seconds.6
Refractory Angina (RA) is defined as a chronic condition (≥3 months in duration) characterized by angina in the setting of coronary artery disease (CAD), which cannot be controlled by a combination of medical therapy, angioplasty/stents or bypass surgery, and where reversible myocardial ischemia has been clinically established to be the cause of the symptoms.7
These patients can be classified as “No Option”.1 But there is another option: TMR.
You are not alone!
- Williams et al. Patients with Coronary Artery Disease Not Amendable to Traditional Revascularization: Prevalence and 3-Year Mortalitiy. Catheterization Cardiovascular Interventions. 2010 May 1;75(6):886-891
- Slicker K, Lane WG, et al. Daily cardiac catheterization procedural volume and complications a an academic medical center. Cardiovasc Diagn Ther. 2016 Oct; 6(5): 446–452.
- Al-Lamee et al. Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. Lancet. November 2, 2017
- Allen KB, Dowling RB, Fudge TL, et al. Comparison of transmyocardial revascularization with medical therapy in patients with refractory angina. N Engl J Med. 1999;341:1029–1036.
- Allen, KB, et al. Adjunctive Transmyocardial Revasularization: Five-Year Follow-up of a Prospective, Randomized Trial. Ann Thorac Surg. 2004;78:458-65.
- Kloner et al. Angina and Its Management. Journal of Cardiovascular Pharmacology and Therapeutics 2017, Vol. 22(3) 199-209
- Mannheimer C, Camici P, Chester MR, et al. The problem of chronic refractory angina; report from the ESC Joint Study Group on the Treatment of Refractory Angina. Eur Heart J 2002;23:355–70.
- Management Of Refractory Angina Pectoris; Cheng et al. Management of Refractory Angina Pectoris. European Cardiology Review 2016;11 (2):69–76
- Tran R, Brazio Ps, et al. Transmyocardial Laser Revascularization Enhances Blood Flow within Bypass Grafts. Innovations 2007;2: 226-230.
- Iwanski et al. Clinical outcomes meta-analysis: measuring subendocardial perfusion and efficacy of transmyocardial laser revascularization with nuclear imaging. Journal of Cardiothoracic Surgery (2017) 12:37
- Iwanski et al. Remodeling an infarcted heart: novel hybrid treatment with transmyocardial revascularization and stem cell therapy. SpringerPlus (2016) 5:738
- Wehberg, KE. Et al. Improved patient outcomes when transmyocardial revascularization is used as adjunctive revascularization. Heart Surg Forum. 2003;6(5):328-30
- Johns Hopkins Medicine. Coronary Artery Bypass Graft Surgery. January 4, 2018
- CardioGenesis SoloGrip® III Handpiece IFU LC0001.002 (01/2015)