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A new minimally invasive treatment is offering hope to Australians living with severe angina that has not improved despite medications, stents or bypass surgery.
Angina—chest discomfort caused by reduced blood flow to the heart—is one of the most common symptoms of coronary heart disease. For most people, medications or procedures such as stents or bypass surgery relieve the symptoms. However, a significant group of patients continue to experience disabling chest pain even after exhausting all standard treatments. This condition is called refractory angina.
Sydney Heart Team’s Professor Martin Ng has performed Australia’s first implantation of the Shockwave Reducer for the treatment of refractory angina — a chronic and often debilitating condition that can leave patients with persistent chest pain, shortness of breath and repeated hospital visits despite exhausting conventional treatment options.
The coronary sinus reducer is a small mesh device inserted through a keyhole procedure into the large vein that drains blood from the heart. By creating a controlled narrowing in this vein, the device is designed to improve blood flow to areas of the heart muscle affected by ongoing ischaemia.
“Despite major advances in cardiology, there remains a group of patients whose angina continues to dominate their daily lives,” Professor Ng said.
“In November 2025, we treated Donald, a patient who had previously undergone bypass surgery and multiple stent procedures, yet remained profoundly disabled by refractory angina. He was on extensive medical therapy and still had no real relief.
“After discussions with the manufacturer, we were able to secure support for his case and undertake Australia’s first coronary sinus reduction procedure.”
Overseas research suggests coronary sinus reduction can reduce the frequency and severity of chest pain, improve the ability to exercise, reduce hospital presentations and improve quality of life.
Professor Ng said the therapy is now supported in European Society of Cardiology guidelines for carefully selected patients treated in experienced centres.
The Shockwave Reducer is not yet approved by Australia’s Therapeutic Goods Administration, and its current use in Australia is limited to compassionate access on a case-by-case basis.
Even so, for patients with severe refractory angina who have been told that no further conventional treatment options remain, this new therapy may offer meaningful hope.
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