After a second bypass operation, many heart patients have no options for increasing blood flow to the heart. This is a growing problem as bypass operations last only about ten years before vessels begin to close again. There are several techniques proposed to address this patient population. The first is to grow new blood vessels with proteins called growth factors. This can be done by using gene therapy or therapeutic angiogenesis.
Initial studies are extremely promising and large multicenter trials are underway.
A second approach is to create new channels for blood flow with lasers or a needle, as reported here. In this treatment, new channels are created for blood to flow from the ventricular chamber to the starving heart muscle. The drawback is the procedure does not necessarily increase blood flow. This can mean less pain for some patients. However, the benefit may be the result of a placebo effect.