San Bortolo Hospital, Italy
Title: Current therapies for refractory angina and potential effects of internal mammary artery occlusion
Biography: Marco Piciche
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.