Right Ventricular Function after Coronary Sinus Narrowing with the Use of the Reducer Device

Coronary sinus narrowing with the use of the Reducer device (Neovasc Inc., Richmond, BC, Canada) is an effective and safe method for improving angina and myocardial perfusion in coronary artery disease patients who suffer from refractory angina despite optimal treatment.

The right ventricle (RV) usually operates under low pressures and normally receives blood supply from the coronary circulation throughout the cardiac cycle. As a result, RV function might be compromised under persistent ischemia.

In the present study we aimed to evaluate the effect of Reducer device Implantation on RV function.

Methods and results: Echocardiography results from 18 patients (mean age 68±14 years, 84% men) implanted with Reducer device at our facility were retrospectively evaluated. No statistically significant differences in stroke volume, fractional area change, tricuspid annulus plane systolic excursion, Tei index, RV systolic pressure and right atrial pressure were found pre and post Reducer device implantation (75.9±16.7 vs 72.7±12, p= 0.4; 41.9±10.4 vs 40±8.4, p=0.35; 18.6±4.5 vs 17.6±4., p=0.84; 0.26±0.1 vs 0.3±0.12, p=0.45; 34.2±9.8 vs 35±13, p=0.17 and 6.5±2.3 vs 7.14±4.2, p=0.23 respectively).

Conclusion: In this retrospective study, parameters of RV function were not found to be improved after a Reducer device implantation. Prospective studies might be warranted to accurately evaluate this potential beneficial effect.