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  Česky / Czech version Vnitř. Lék., 48, 2002, No. 5, p. 363-367
 
Angiographic Marginally Important Coronary Stenoses - Implementation or Postponement of Intervention Based on Myocardial Fractional Flow Reserve 
Mates M., Hraboı V., Vojáèek J., Hájek P., Malý M.,  

Divize kardiologie Interní kliniky 2. lékaøské fakulty UK, Praha, pøednosta doc. MUDr. M. Kvapil, CSc. Kardiocentrum dospìlých FN v Motole, Praha, vedoucí lékaø prof. MUDr. J. Vojáèek, DrSc.
 


Summary:

       Introduction.When evaluating angiographically marginal coronary stenoses (i.e. 40-70% reduction of the diameter of the arterial lumen) it is under certain conditions difficult to decide on their actual functional impact. Assessment of the fractional flow reserve (FFR) is a simple method based on assessment of intracoronary pressures during pharmacologically induced hyperaemia. For the severity of stenosis according to previous studies the liminal values is FFR lower than 0.75; furthermore it was proved that intervention of angiographically marginal stenoses with FFR values of 0.75 or more can be safely postponed. Objective: Test the safety of FFR examination and take in a group of patients with marginally severe stenosis further steps according to results of FFR assessment. Material and methods: During the period from January to Juky 2000 FFR asses- sments were made in a total of 34 patients (11 women, 23 men, mean age 62 ± 12 years) who suffered from marginal stenosis of some coronary vessel. The FFR examination took place under pharmacologically induced hyperaemia after intracoronary adenosine administration. Results. Measurements were made in a total of 41 stenoses. Only in two a value lower than 0.75 was found. In these patients coronary intervention was implemented; intervention was also made in two patients on account of technical problems and inconsistent results of FFR measurements. A FFR value of 0.75 or less was found in 37 stenoses (90 %) and intervention was therefore postponed. Examination and the immediate subsequent course were without complications. Conclusion. Ac- cording to initial experience FFR examination is a safe, simple and easily reproducible method. Based on the results of assessment and knowledge of the accomplished studies in the group of marginally significant stenoses in a great proportion of patients coronary intervention was po- stponed.

        Key words: Coronary angioplasty - Myocardial fractional flow reserve - Ischaemic heart disease
       

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