Fractional Flow Reserve for Intermediate Coronary Artery Stenosis in Nepal
Journal Title: Nepalese Heart Journal - Year 2015, Vol 12, Issue 2
Abstract
Background and Aims: : Coronary angiogram detects anatomical lesion, however, has limited ability to assess physiological signifcance. Fractional flow reserve is used to determine functional signifcance of stenosis and is measured by the ratio of mean distal coronary pressure to mean aortic pressure during maximum hyperemia. Recently, fractional flow reserve was started in Nepal. This study intends to explore the extent of determination of hemodynamic signifcance of intermediate coronary stenosis by fractional flow reserve, thereby guiding revascularization. Methods: Consecutive patients with intermediate lesion undergoing fractional flow reserve from July 2014 to March 2015 were included, if fractional flow reserve ≤0.80 then considered to be signifcant and need for revascularization determined. The study subjects were divided into two groups, one having physiologically signifcant stenosis and another with physiologically non signifcant lesion and followed up to three months. Results: Total forty four patients had fractional flow reserve done in ffty eight intermediate coronary artery lesions. The age ranged from 33 to 78 with the mean age of 58.25±10.08 years. Majority of them (75%) were male. Left anterior descending artery was commonest in 37(63.8%), followed by left circumflex 13(22.4%), then right coronary artery in 8(13.8%) target lesions. None of the patient had death, myocardial infarction or repeat revascularization during follow up. Out of 58 intermediate lesions assessed, 17(29.31%) had signifcant fractional flow reserve value, whereas 41(70.69%) had physiologically non signifcant lesion. Conclusion: Around one third (29.31%) of intermediate coronary artery stenosis are functionally signifcant by fractional flow reserve in the context of Nepal, thus it could be useful guide for optimal revascularization.
Authors and Affiliations
Mahesh Bhattarai| Deparrtment of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Arun Maskey| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Ram Kishore Sah| Deparrtment of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Himamshu Nepal| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Rabindra Pandey| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Rikesh Tamrakar| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Amit Agrawal| Deparrtment of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Rabi Malla| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Rajib Rajbhandari| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Chandra Mani Adhikari| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Yadav Kumar Dev Bhatta| Department of Cardiology,Shahid Gangalal National Heart Centre, Bansbari, Kathmandu
Keywords
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- EP ID EP15761
- DOI http://dx.doi.org/10.3126/njh.v12i2.13384
- Views 385
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