ABSTRACT
Ischemic heart disease is the leading cause of mortality in North America. Approximately 465000 000 new cases are diagnosed in the USA each year, and 15 million new cases are diagnosed worldwide.1,2 Standard treatments for coronary artery disease include percutaneous coronary interventions and coronary artery bypass grafting.3,4 However, approximately 10% of patients are not ideal candidates for conventional revascularization procedures, because of diffuse coronary disease. These patients may have no therapeutic options other than cardiac transplantation. Newer experimental therapies involve a ‘biological bypass’ without intraluminal or surgical interventions. In the last 10 years, two treatments have become available for no-option patients with diffuse atherosclerotic coronary disease: transmyocardial laser revascularization and angiogenic gene or protein therapy.
