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dc.contributor.authorPellicano, Mariano
dc.contributor.authorDe Bruyne, Bernard
dc.contributor.authorToth, Gabor G.
dc.contributor.authorCasselman, Filip
dc.contributor.authorWijns, William
dc.contributor.authorBarbato, Emanuele
dc.date.accessioned2018-09-20T16:21:22Z
dc.date.available2018-09-20T16:21:22Z
dc.date.issued2016-12-23
dc.identifier.citationPellicano, 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),
dc.identifier.issn0195-668X,1522-9645
dc.identifier.urihttp://hdl.handle.net/10379/13441
dc.description.abstractThe 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.
dc.publisherOxford University Press (OUP)
dc.relation.ispartofEuropean Heart Journal
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 Ireland
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/3.0/ie/
dc.subjectfractional flow reserve
dc.subjectcoronary artery bypass graft
dc.subjectrevascularization
dc.subjectmultivessel disease
dc.subjectleft main coronary disease
dc.subjectsaphenous-vein-grafts
dc.subjectinternal thoracic artery
dc.subject5-year follow-up
dc.subjectaortic-stenosis
dc.subjectmultivessel evaluation
dc.subjectradial-artery
dc.subjectfunctional severity
dc.subjectmammary artery
dc.subjectsyntax score
dc.subjectdisease
dc.titleFractional flow reserveto guide and to assesscoronary artery bypass grafting
dc.typeArticle
dc.identifier.doi10.1093/eurheartj/ehw505
dc.local.publishedsourcehttps://academic.oup.com/eurheartj/article-pdf/38/25/1959/17983774/ehw505.pdf
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Attribution-NonCommercial-NoDerivs 3.0 Ireland
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