What question did this study set out to answer?

To retrospectively evaluate the physiological significance and clinical impact of computed tomography–derived fractional flow reserve in patients with anomalous aortic origin of a coronary artery.

March 17, 2021SHILAP Revista de lepidopterologíaOpen Access

Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography–Derived Fractional Flow Reserve

View Full Paper

Ask AI

Bookmark

Why the study?

Anomalous aortic origin of a coronary artery is increasingly diagnosed, but whether noninvasive anatomical and functional evaluation using FFRCT could aid in patient management remained to be evaluated.

Does FFRCT analysis provide physiological and clinical prognostic value in patients with anomalous aortic origin of a coronary artery?

Population

54 patients with ANOCOR and successful FFRCT analyses

Comparison

FFRCT analysis in conservative treatment vs coronary revascularization

Design

Retrospective registry-based study

Follow-up

5 years

Authors

JAJulien AdjedjInterventional Cardiology FHFabien HyafilCardiac Imaging XFX. Halna du FretayAssistance Publique – Hôpitaux de Paris

Discussion

Member takes

Implication

FFRCT shows moderate hemodynamic effects in ANOCOR with few events; leaves open its role in risk stratification.

Key Points

To retrospectively evaluate the physiological significance and clinical impact of computed tomography–derived fractional flow reserve in patients with anomalous aortic origin of a coronary artery.
Retrospective analysis of the ANOCOR registry evaluating patients diagnosed between January 2010 and January 2013 with 5-year clinical follow-up (N=54 with adequate coronary CT angiography; mean age 60±13 years).
CT-derived fractional flow reserve (FFRCT) was computed along the anomalous vessel course, and clinical outcomes were tracked using a composite endpoint of cardiac death, myocardial infarction, and unplanned revascularization.
FFRCT values exhibited a moderate physiological decrease from 1.0 at the ostium to 0.90±0.10 downstream of the ectopic course and 0.82±0.11 in the distal vessel, with no significant difference between at-risk and not at-risk anatomy.
Initial management included conservative medical therapy in 38 patients (70%) and coronary revascularization in 16 patients (30%).
Over the 5-year follow-up period, only one unplanned percutaneous revascularization occurred, with no reported cardiac deaths or myocardial infarctions.

Structured PICO

Does FFRCT analysis provide physiological and clinical prognostic value in patients with anomalous aortic origin of a coronary artery?

Population

54 patients with anomalous aortic origin of a coronary artery (ANOCOR) detected during invasive coronary angiography or coronary CT angiography, average age 60±13 years.

Intervention

Computed Tomography-Derived Fractional Flow Reserve (FFRCT) analysis

Outcome

Clinical composite end point of cardiac death, myocardial infarction, and unplanned revascularization at 5-year follow-upcomposite

FFRCT demonstrates a moderate hemodynamic decrease in anomalous coronary arteries, which is associated with a very low risk of cardiovascular events at 5 years in a middle-aged population.

Cite This Study

Adjedj et al. (2021) studied this question.

synapsesocial.com/papers/69d8978cd2f7327e70ae3929 https://doi.org/10.1161/jaha.120.018593

Topics

Coronary CT angiography

View Full Paper

Ask AI

Bookmark

Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography–Derived Fractional Flow Reserve

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography–Derived Fractional Flow Reserve

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider