Fractional flow reserveto guide and to assesscoronary artery bypass grafting
De Bruyne, Bernard
Toth, Gabor G.
MetadataShow full item record
This item's downloads: 0 (view details)
Pellicano, Mariano; De Bruyne, Bernard; Toth, Gabor G. Casselman, Filip; Wijns, William; Barbato, Emanuele (2016). Fractional flow reserveto guide and to assesscoronary artery bypass grafting. European Heart Journal 38 (25),
The aim of this review is to highlight the role of invasive functional evaluation in patients in whom coronary artery bypass graft (CABG) is indicated, and to examine the clinical evidence available in favour of fractional flow reserve (FFR) adoption in these patients, outline appropriate use, as well as point out potential pitfalls. FFR after CABG will also be reviewed, highlighting its correct interpretation and adoption when applied to both native coronary arteries and bypass grafts. Practice European guidelines support the use of FFR to complement coronary angiography with the highest degree of recommendation (Class IA) for the assessment of coronary stenosis before undertaking myocardial revascularization when previous non-invasive functional evaluation is unavailable or not conclusive. As a result, FFR has been adopted in routine clinical practice to guide clinicians decision as to whether or not perform a revascularization. Of note, due to the increasing confidence of the interventional cardiologists, FFR guidance is also being implemented to indicate or guide CABG. This is in anticipation of supportive clear-cut evidence, since recommendations for FFR adoption were based on randomized clinical trials investigating percutaneous coronary intervention (PCI) strategies in which patients with typical indications for CABG were excluded (e.g. left main disease, valvular disease, and coronary anatomy unsuitable for PCI). Based on the critical appraisal of the literature, FFR can play an important role in risk stratification and determining management strategy of patients either before or after CABG.
Showing items related by title, author, creator and subject.
Unknown author (Oxford University Press (OUP), 2017-01-01)The primary hypothesis of the ROMA trial is that in patients undergoing primary isolated non-emergent coronary artery bypass grafting, the use of 2 or more arterial grafts compared with a single arterial graft (SAG) is ...
Comparison of in vitro human endothelial cell response to self-expanding stent deployment in a straight and curved peripheral artery simulator Ghriallais, R. N.; McNamara, L.; Bruzzi, M. (The Royal Society, 2013-01-30)Haemodynamic forces have a synergistic effect on endothelial cell (EC) morphology, proliferation, differentiation and biochemical expression profiles. Alterations to haemodynamic force levels have been observed at curved ...
Ní Ghriallais, Ríona (2012-08-31)The femoropopliteal artery is a complex and challenging environment for stent placement. It is subject to large deformations due to the impact of physiological loading from surrounding muscles. It is also subject to changing ...