Key result
Invasive functional assessment to guide CABG lacks definitive evidence pending ongoing trials.
Why the study?
Does invasive functional assessment improve outcomes compared to anatomic assessment in patients undergoing surgical revascularization for coronary artery disease?
Does invasive functional assessment improve outcomes compared to anatomic assessment in patients undergoing surgical revascularization for coronary artery disease?
This review highlights the current limited data and ongoing trials regarding the use of invasive functional assessment to guide coronary artery bypass grafting.
Evidence too limited for routine functional guidance in CABG; leaves open its role pending ongoing trials.
In patients with stable coronary artery disease, percutaneous coronary intervention is associated with improved outcomes if the lesion is deemed significant by invasive functional assessment using fractional flow reserve. Recent studies have shown that a revascularization strategy using instantaneous wave-free ratio is noninferior to fractional flow reserve in patients with intermediate-grade stenoses. The decision to perform coronary artery bypass grafting surgery is usually based on anatomic assessment of stenosis severity by coronary angiography. The data on the role of invasive functional assessment in guiding surgical revascularization are limited. In this review, we discuss the diagnostic and prognostic significance of invasive functional assessment in patients considered for coronary artery bypass grafting. In addition, we critically discuss ongoing and future clinical trials on the role of invasive functional assessment in surgical revascularization.
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Baibhav et al. (2018) conducted a review in Coronary artery disease. Invasive functional assessment was evaluated. Invasive functional assessment for guiding surgical revascularization in patients considered for coronary artery bypass grafting currently has limited data, highlighting the need for ongoing trials.
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