{
  "abstract": "BGD and Aims Coronary Sinus reducer (CSR) is a technology that has been designed to help patients who have refractory angina – reduce symptoms and improve quality of life.The CSR has shown in Randomised controlled trials that it reduces angina symptoms in patients who have been refractory to optimal medical therapy and coronary revascularisation or deemed not suitable for further revascularisation (1).The objective of this study is to assess the safety, complexity and efficacy of the CSR in patients with refractory angina in a single centre (Essex Cardiothoracic Centre)Methods Fifteen consecutive patients with refractory angina who were judged not suitable for further coronary revascularisation and had objective evidence of myocardial ischaemia underwent CSR implantation between February 2022 and September 2024. The myocardial Ischaemia assessment was done using Cardiac Magnetic Resonance imaging (CMR) for all patients recruited.Three endpoints were assessed:Safety endpoints were evaluated by the success of procedure and absence of device related complications.Complexity endpoints were evaluated by ease of coronary sinus intubation, number of catheters used, number of wires used, shapes of catheter/wires employed, total length of time in lab and amount of contrast volume used.Efficacy endpoints assessed at > 4months follow up, a reduction in Canadian Cardiovascular Society (CCS) angina class, improvement in Quality of life assessed using the Seattle Angina questionnaire.Results All procedures were highly successful, and no device related complications reported.Overall, the procedure complexity varied between patients, with mean and median fluoroscopy times of 16.8minutes and 11minutes, respectively.There was an improvement in CCS Class from mean of 3.53 to 1.8 (p<0.002) as seen in figure 1. All other modalities in the Seattle Angina questionnaire improved significantly, in particular coping to activities of daily living. More than 50% of patient reported being highly satisfied with the care they received.Conclusion CSR implantation for chronic refractory angina is a safe procedure, effective at improving the symptoms and quality of life of our patients who are deemed not suitable for other coronary revascularisation interventions.The complexity of cases varied due to anatomical differences.Future direction:Pre-planning for CSR implantation procedures using other imaging modalities such as Computerised Tomography (CT) scans. We hope this will reduce procedure and fluoroscopy screening time.",
  "authors": [
    {
      "affiliations": [
        "Essex Cardiothoracic Centre, Basildon, United Kingdom",
        "Musgrove Park Hospital, Taunton, United Kingdom"
      ],
      "name": "Joseph Appiah"
    },
    {
      "affiliations": [
        "Essex Cardiothoracic Centre, Basildon, United Kingdom",
        "Anglia Ruskin School of Medicine, Chelmsford, United Kingdom"
      ],
      "name": "John Davis"
    },
    {
      "affiliations": [
        "Essex Cardiothoracic Centre, Basildon, United Kingdom",
        "Anglia Ruskin School of Medicine, Chelmsford, United Kingdom"
      ],
      "name": "Thomas Keeble"
    }
  ],
  "title": "504 Coronary sinus reducer implantation in chronic refractory angina: safety, procedural complexity and quality-of-life outcomes from a single centre",
  "uid": "3c993bfe-2a79-5e4b-87fd-b3765e6ecebe"
}