INITIAL EXPERIENCE OF FRACTIONAL FLOW RESERVE IN 30 PATIENTS WITH MODERATE CORONARY ARTERY LESIONS AT ARMED FORCES INSTITUTE OF CARDIOLOGY

Fractional Flow Reserve

Abstract

Objective: To evaluate our initial experience of Fractional Flow Reserve (FFR) for decision making in coronary revascularization in moderate lesions.
Study Design: A descriptive study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases from August 2009 to August 2010.
Patients and Methods: A total of 30 consecutive patients who underwent FFR at AFIC/NIHD from August 2009 to August 2010. These were the cases in which decision regarding PCI was difficult on visual assessment alone as experienced operators differed in their opinion. A 0.014” FFR wire was used and pressure gradients across the lesions were noted
Results: A total of 30 patients with 44 moderate lesions on coronary angiography were evaluated in our initial experience. Amongst these, 27 (61.4%) LAD lesions were studied (20 lesions had an FFR > 0.80 while 7 (15.9%) had an FFR 0.80 or less). Seven (15.9%) lesions of LCX were evaluated (5 had an FFR > 0.80 and 2 had 0.80 or less). Seven (15.9%) lesions were of RCA (4 had an FFR >0.80, 3 had 0.80 or less). One case of LMS lesion was found to be non-critical. Two (4.5%) vein graft lesions were included of which one was found to be angiographically critical, (FFR 0.72). Out of the total 44 lesions studied 14 (31.82%) lesions were critical with an FFR 0.80 or less, which were stented. Thus 30 stents were saved. This reduced the cost, as well as the un-necessary hazards and risks associated with PCI and the issue of difference in opinion was put to rest.
Conclusion: We thus conclude that FFR is a very important tool in guiding the interventionist for planning PCI in moderate lesions