Key result
Pressure-derived collateral fractional flow reserve (FFRcoll) correlated significantly with LVEF (P<0.001) but showed no significant variation after left coronary artery bypass grafting.
Why the study?
Does pressure-derived collateral fractional flow reserve correlate with angiographic collaterality or LVEF, and does it change after left coronary revascularization in patients with three vessel disease and right coronary occlusion?
Observational (n=8)
Does pressure-derived collateral fractional flow reserve correlate with angiographic collaterality or LVEF, and does it change after left coronary revascularization in patients with three vessel disease and right coronary occlusion?
p-value: p=<0.001
Functional collaterality is better estimated by LVEF than angiographic appearance, and the lack of FFRcoll change after left coronary grafting supports the justification for grafting the occluded right coronary artery.
LVEF may better reflect functional collaterality than angiography in 3VD; case report leaves open FFRcoll utility for occluded RCA decisions.
The aim of this study was the determination of the pressure-derived collateral fractional flow reserve (FFR(coll)) in patients with three vessel disease and chronic occlusion of the right coronary artery undergoing surgical complete revascularization with the off-pump technique. The angiograms of eight patients were preoperatively analysed to quantify collaterality. FFR(coll) was determined before any revascularization (FFR(coll) 0), and after revascularization of the left coronary arteries, (FFR(coll) 1). FFR(coll) 0 was compared to the Rentrop grade, to the left ventricular ejection fraction (LVEF), and to FFR(coll) 1. No correlation was demonstrated between preoperative Rentrop grade and FFR(coll) 0. There was a linear statistically significant correlation between FFR(coll) 0 and LVEF (P;ie0.001). No significant variation of the FFR(coll) index was observed after performing left coronary artery bypass grafts. Collaterality observed on the coronary angiogram cannot be used as an estimation of the functional collaterality, which can be better appreciated with the LVEF. The absence of variation of FFRcoll before and after left coronary artery revascularization suggests that grafting of the occluded right coronary artery remains justified.
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Jean Philippe Verhoye (2005) conducted an observational in Three vessel disease and chronic occlusion of the right coronary artery (n=8). Off-pump surgical complete revascularization vs. Pre-revascularization baseline was evaluated on Variation of FFR(coll) index after left coronary artery bypass grafts and correlation with LVEF (p=<0.001). Pressure-derived collateral fractional flow reserve (FFRcoll) correlated significantly with LVEF (P<0.001) but showed no significant variation after left coronary artery bypass grafting.
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