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Six-year status quo with fractional flow reserve
Archives of Cardiovascular Disease (2010) 103, 57—58
IMAGE
Six-year status quo with fractional flow reserve Six années de status quo coronaire avec la FFR Gilles Rioufol ∗, Gérard Finet Inserm U886, Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France Received 3 August 2009; received in revised form 5 August 2009; accepted 6 August 2009 Available online 27 November 2009
KEYWORDS FFR; Stable angina; Long follow-up
MOTS CLÉS FFR ; Suivi ; Angine stable
A 76-year-old diabetic woman with a history of surgical revascularization in 1997 (left internal mammary artery [LIMA] on left anterior descending) was referred twice afterwards (June 2001 and February 2008) for stable angina. No stress test was available. In part of the invasive evaluations, an intermediate lesion at the proximal part of the right coronary artery (RCA) was routinely measured by fractional flow reserve (FFR) and proved functionally non-significant. The LIMA was checked and remained perfect and the ischaemia was allocated on both occasions to a minor marginal branch. Based upon the FFR value above 0.75, the clinical prognosis was considered excellent for the RCA and for the patient. Medical therapy was implemented and no revascularization was attempted on the RCA. Moreover, FFR values on the RCA were roughly similar on both occasions, indicating stability. FFR is a valuable online clinical tool in the catheterization laboratory that provides accurate functional data for a given coronary stenosis. An FFR value greater than 0.75 or 0.80 allows postponement of revascularization in cases of either single- or multivessel disease. In the case of single-vessel disease, a 5-year clinical follow-up reinforces this postponement strategy. Our example of an intermediate RCA lesion reassessed after 79 months provides support for this functional approach (Fig. 1). Conflict of interest: none.
∗
Corresponding author. Department of Hemodynamics, Cardiovascular Hospital, BP Lyon-Monchat, 69394 Lyon Cedex 03, France. Fax: +33 4 72 68 49 27. E-mail address: [email protected] (G. Rioufol). 1875-2136/$ — see front matter © 2009 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.acvd.2009.08.007
58
Figure 1.
G. Rioufol, G. Finet
Right coronary angiogram and its associated FFR measurement after an interval of six years.
IMAGE
Six-year status quo with fractional flow reserve Six années de status quo coronaire avec la FFR Gilles Rioufol ∗, Gérard Finet Inserm U886, Department of Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France Received 3 August 2009; received in revised form 5 August 2009; accepted 6 August 2009 Available online 27 November 2009
KEYWORDS FFR; Stable angina; Long follow-up
MOTS CLÉS FFR ; Suivi ; Angine stable
A 76-year-old diabetic woman with a history of surgical revascularization in 1997 (left internal mammary artery [LIMA] on left anterior descending) was referred twice afterwards (June 2001 and February 2008) for stable angina. No stress test was available. In part of the invasive evaluations, an intermediate lesion at the proximal part of the right coronary artery (RCA) was routinely measured by fractional flow reserve (FFR) and proved functionally non-significant. The LIMA was checked and remained perfect and the ischaemia was allocated on both occasions to a minor marginal branch. Based upon the FFR value above 0.75, the clinical prognosis was considered excellent for the RCA and for the patient. Medical therapy was implemented and no revascularization was attempted on the RCA. Moreover, FFR values on the RCA were roughly similar on both occasions, indicating stability. FFR is a valuable online clinical tool in the catheterization laboratory that provides accurate functional data for a given coronary stenosis. An FFR value greater than 0.75 or 0.80 allows postponement of revascularization in cases of either single- or multivessel disease. In the case of single-vessel disease, a 5-year clinical follow-up reinforces this postponement strategy. Our example of an intermediate RCA lesion reassessed after 79 months provides support for this functional approach (Fig. 1). Conflict of interest: none.
∗
Corresponding author. Department of Hemodynamics, Cardiovascular Hospital, BP Lyon-Monchat, 69394 Lyon Cedex 03, France. Fax: +33 4 72 68 49 27. E-mail address: [email protected] (G. Rioufol). 1875-2136/$ — see front matter © 2009 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.acvd.2009.08.007
58
Figure 1.
G. Rioufol, G. Finet
Right coronary angiogram and its associated FFR measurement after an interval of six years.