scholarly journals Fractional Flow Reserve in the Diagnosis of Ischemic Heart Disease in a Patient with Coronary Artery Ectasia

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 17
Author(s):  
Malgorzata Zalewska-Adamiec ◽  
Lukasz Kuzma ◽  
Hanna Bachorzewska-Gajewska ◽  
Slawomir Dobrzycki
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Fractional Flow Reserve ◽  
Connective Tissue Diseases ◽  
Heart Team ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Retrosternal Pain ◽  
Artery Disease

Coronary artery ectasias (CAE) are diffuse dilatations of coronary artery segments with a diameter 1.5 times greater than the largest adjacent normal segment of the vessel. They are found in 0.3–5.0% of coronary angiography. Risk factors for CAE include atherosclerosis, previous percutaneous coronary interventions, arterial inflammation and connective tissue diseases. The diagnosis of CEA in a patient is a considerable diagnostic and therapeutic problem due to the unfavorable prognosis and the lack of guidelines. We present a case of a 69-year-old male patient with a history of retrosternal pain admitted to the clinic for the diagnosis of coronary artery disease. In coronary angiography, numerous ectases of the main coronary arteries and atherosclerotic lesions causing border stenosis of the left anterior descending (LAD), diagonal (2D) and marginal branch (OM). The heart team decided to assess the significance of the changes with the fractional flow reserve (FFR). The FFR was performed and haemodynamically insignificant stenoses of the ectatically dilated coronary arteries were found. The patient was qualified for conservative treatment.

scholarly journals Fractional Flow Reserve in Choosing the Tactics of Interventional Treatment of Multilevel Coronary Artery Lesions

2021 ◽  
pp. 26-29
Author(s):  
Andrii Yu. Gavrylyshyn ◽  
Sergii V. Salo ◽  
Olena V. Levchyshyna ◽  
Andrii K. Logutov ◽  
Vasyl V. Lazoryshynets
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Fractional Flow Reserve ◽  
Invasive Coronary Angiography ◽  
Stable Coronary Artery Disease ◽  
Interventional Treatment ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease

When choosing tactics for the treatment of patients with stable coronary artery disease, invasive coronary angiography remains the gold standard for diagnosis and is a crucial method in choosing tactics and volume of revascularization. However, in the presence of borderline (>50-70%), multilevel lesions of the coronary artery, there is a need for additional assessment of the physiological significance of each stenosis. The aim. To develop an algorithm to optimize the use of fractional flow reserve (FFR) measurement in interventional treatment of borderline (>50-70%), multilevel lesions of coronary arteries, to show the safety of “functional revascula­ rization” in comparison with traditional angiography. Materials and methods. The study included 32 patients who were treated at the National Amosov Institute of Cardiovascular Surgery in the period from 2017 to 2021 (the vast majority were men – 25 patients (67%) and 7 (33%) women) aged 60.3±8.3 years who had >50-75% multilevel lesions of one of the main coronary arteries according to selective invasive coronary angiography. The patients were divided into two groups: 1) Angiographic group (n = 17, 53%), where the volume and tactics of revascularization were determined only by angiography (maximum complete anatomical revascularization); 2) Functional group (n=15, 47%) (combination of angiography data and FFR measurement, the so-called “functional revascularization”). Conclusions. An effective and safe algorithm for measuring FFR in multilevel lesions (reducing the number of implanted stents) is shown.

scholarly journals Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Datasets: The Next Frontier in Noninvasive Assessment of Coronary Artery Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Caroline Ball ◽  
Gianluca Pontone ◽  
Mark Rabbat
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Fractional Flow Reserve ◽  
Cost Of Care ◽  
Heart Team ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Flow Reserve ◽  
Artery Disease

Fractional flow reserve (FFR) derived from coronary CTA datasets (FFRCT) is a major advance in cardiovascular imaging that provides critical information to the Heart Team without exposing the patient to excessive risk. Previously, invasive FFR measurements obtained during a cardiac catheterization have been demonstrated to reduce contrast use, number of stents, and cost of care and improve outcomes. However, there are barriers to routine use of FFR in the cardiac catheterization suite. FFRCT values are obtained using resting 3D coronary CTA images using computational fluid dynamics. Several multicenter clinical trials have demonstrated the diagnostic superiority of FFRCT over traditional coronary CTA for the diagnosis of functionally significant coronary artery disease. This review provides a background of FFR, technical aspects of FFRCT, clinical applications and interpretation of FFRCT values, clinical trial data, and future directions of the technology.

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