Bridging the Gap Between Myocardial Ischemia and Graft Patency

The fractional flow reserve (FFR) was calculated as the ratio of the pressure proximal and distal to stenotic lesions. It provides the cutoff value for myocardial ischemia, even in cases of moderate stenosis that might appear normal upon visual assessment. In coronary artery bypass grafting, the intraluminal pressure is useful for predicting the competitive flow or ‘string sign’ in arterial grafts, including the internal thoracic artery. This review article discusses the advantages and challenges of FFR from the perspective of coronary surgeons.