Use of the Neovasc Coronary Sinus Reducer System for the Treatment of Refractory Angina Pectoris in Patients With Ngina Class 3-4 Who Are Not Candidates for Revascularization

Inclusion Criteria: * \>18 years old * Symptomatic CAD with chronic refractory angina pectoris classified as Canadian Cardiovascular Society (CCS) grade III or IV despite attempted optimal medical therapy for thirty days prior to screening * Non-candidate for surgical or percutaneous coronary intervention, as determined by 2 independent Professors of Internal medicine * Reversible ischemia of the left ventricular wall demonstrated by Dobutamine Stress Echocardiography (Dobutamine ECHO; DSE), or by Thallium Spect Exclusion Criteria: * Recent (within three months) acute coronary syndrome * Recent (within six months) PCI or CABG * Unstable angina (recent onset angina, crescendo angina, or rest angina with ECG changes) during the thirty days prior to screening * De-compensated congestive heart failure or hospitalization due to CHF during the three months prior to screening * Life threatening rhythm disorders or any rhythm disorders that would require placement of an internal defibrillator and or pacemaker * Severe chronic obstructive pulmonary disease as indicated by a forced expiratory volume in one second that is less than 55% of the predicted value * Severe valvular heart disease * Patient with pacemaker or defibrillator electrode in the right atrium, right ventricle, or coronary sinus * Patient having undergone tricuspid valve replacement or repair * Known allergy to stainless steel or nickel * Patient with anomalous or abnormal CS as demonstrated by angiogram. Abnormality defined as: Abnormal CS anatomy (e.g., tortuosity, aberrant branch, persistent left SVC) and/or; CS diameter at the site of implantation\> 12mm