Key result
Fractional flow reserve measurement of an intermediate left main coronary artery stenosis yielded non-ischaemic values in a small daughter vessel but ischaemic values in larger vessels, demonstrating the importance of transducer location.
Why the study?
The impact of daughter vessel size and the amount of subtended myocardium on FFR evaluation of intermediate LMCA stenosis has received little attention.
Does the choice of daughter vessel affect FFR measurement of intermediate left main coronary artery stenosis?
Case Report (n=1)
Does the choice of daughter vessel affect FFR measurement of intermediate left main coronary artery stenosis?
FFR evaluation of left main stenosis requires transducer placement in a daughter vessel with a large subtended myocardial territory to avoid falsely non-ischemic results.
Choice of daughter vessel may affect FFR accuracy in left main stenosis; single case leaves open need for prospective validation.
Fractional flow reserve (FFR) evaluation of intermediate left main coronary artery (LMCA) stenosis has been validated in clinical decision-making. However, the size of the daughter vessel, in which the FFR transducer is placed and the amount of myocardium it subtends, has received less attention. We present a case that demonstrates the importance of transducer location, size of the daughter vessel and the amount of subtended myocardium in evaluation of LMCA stenosis, pointing out potential pitfalls.
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Almomani et al. (2019) conducted a case report in Intermediate left main coronary artery (LMCA) stenosis (n=1). Fractional flow reserve (FFR) was evaluated. Fractional flow reserve measurement of an intermediate left main coronary artery stenosis yielded non-ischaemic values in a small daughter vessel but ischaemic values in larger vessels, demonstrating the importance of transducer location.
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