Author + information
- Samer Mansour,
- Ayoub El Hammiri,
- Alexis Matteau,
- Brian Potter,
- Nicolas Noiseux,
- Louis-Mathieu Stevens and
- François Gobeil
Background: Fractional Flow Reserve (FFR) is currently validated as an important tool in the hemodynamic evaluation of coronary stenosis. Some studies reported that Coronary Artery Bypass Graft (CABG) on lesions with normal FFR arteries might result in early graft patency compromise. However, the interpretation of FFR results may differ between interventional cardiologists and cardiac surgeons. We aim to evaluate the appropriateness of CABG implantation by cardiac surgeons based on FFR evaluation.
Methods: All patients having FFR evaluation of coronary lesion referred for CABG were screened between January 2013 and December 2014. Coronary lesions assessed by FFR were classified in two groups: Appropriate CABG or Inappropriate CABG. Inappropriateness was defined as negative FFR resulting in CABG or positive FFR without CABG.
Results: FFR assessment was performed on 108 stenosis in 83 patients referred for CABG surgery. The mean age was 65 ±10 years. Patients were males in 74%, hypertensive 70% and diabetics in 44%. The clinical presentation was Non ST-Elevation Myocardial Infarction in 31% and stable angina in 34% of cases. Total number of CABG 78 (72%) and Inappropriate CABG was recorded in 16%. The inappropriate CABG was more frequent on lesions with negative FFR as compared to lesion with positive FFR (50% vs. 4% respectively; p<0,0001)
Lesions with inappropriate CABG and negative FFR had a trend to be more severe as compared to ungrafted lesions (52% vs. 47% respectively; p=0,08).
Conclusions: To our knowledge this is the first report addressing the integration of FFR results by cardiac surgeons in patients referred for CABG surgery. Inappropriate CABG occurred mainly in patients with negative FFR. The impact on adverse clinical events needs to be assessed in large clinical trials.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Interventional Cardiology: Intravascular Physiology and Endothelial Function
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1115-182
- 2017 American College of Cardiology Foundation