Key result
Virtual CABG on high FFR stenosis drives ~237% higher anastomotic OSI versus low FFR.
Why the study?
FFR-guided CABG is clinically more effective than angiography-guided CABG, but the hemodynamic mechanism explaining this advantage has not been characterized.
Does the fractional flow reserve (FFR) value of a moderate coronary stenosis affect the hemodynamic parameters of a bypass graft in a computational model?
Population
2 patients with 70% coronary stenosis and clinical FFRs of 0.7 and 0.95
Comparison
Virtual bypass surgery on stenosis with FFR 0.7 vs FFR 0.95
Design
Computational hemodynamic modeling study using a 0-3D coupled multiscaled model
Authors
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May warrant caution grafting high-FFR lesions; hypothesis-generating for FFR-guided CABG outcomes.
Does the fractional flow reserve (FFR) value of a moderate coronary stenosis affect the hemodynamic parameters of a bypass graft in a computational model?
Computational modeling demonstrates that grafting a coronary artery with a high FFR value creates adverse hemodynamics (high oscillatory shear index) at the anastomosis, providing a mechanistic explanation for higher graft failure rates in non-ischemic lesions.
Li et al. (2021) studied Coronary artery stenosis (n=2). Virtual coronary artery bypass grafting (CABG) vs. Low FFR (0.7) vs High FFR (0.95) stenosis was evaluated on Hemodynamic parameters including flow rate, wall shear stress (WSS), and oscillatory shear index (OSI). Virtual CABG on a high FFR (0.95) stenosis resulted in a significantly higher oscillatory shear index (0.1264 vs 0.0375) at the anastomosis compared to a low FFR (0.7) stenosis.
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