J 2021

Changes in surgical revascularization strategy after fractional flow reserve

FOURNIER, S., G. G. TOTH, B. DE BRUYNE, Petr KALA, F. L. RIBICHINI et. al.

Basic information

Original name

Changes in surgical revascularization strategy after fractional flow reserve

Authors

FOURNIER, S., G. G. TOTH, B. DE BRUYNE, Petr KALA (203 Czech Republic, belonging to the institution), F. L. RIBICHINI, F. CASSELMAN, R. RAMOS, Z. PIROTH, A. PICCOLI, M. PENICKA, M. MATES, Petr NEMEC (203 Czech Republic), F. VAN PRAET, B. STOCKMAN, I. DEGRIEK, M. PELLICANO and E. BARBATO (guarantor)

Edition

Catheterization and Cardiovascular Interventions, Hoboken, Wiley-Blackwell, 2021, 1522-1946

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.585

RIV identification code

RIV/00216224:14110/21:00123843

Organization unit

Faculty of Medicine

UT WoS

000638603200001

Keywords in English

coronary artery disease; coronary bypass grafts; fractional flow reserve

Tags

Tags

International impact, Reviewed
Změněno: 19/1/2022 12:43, Mgr. Tereza Miškechová

Abstract

V originále

Aims In the randomized GRAFFITI trial, surgeons drew their strategy based on coronary angiography. When patients were randomized to fractional flow reserve (FFR)-guidance, surgeons were informed of the FFR values and asked to redraw their strategy. The aim of this study was to investigate the changes induced by FFR knowledge. Methods and Results The intended and performed strategy (before and after FFR) were compared. Among 172 patients, 84 with 300 lesions were randomized to the FFR-guided group. The intended strategy was to bypass 236 stenoses:108 with a venous and 128 with an arterial graft. After disclosing FFR, a change in strategy occurred in 64 lesions (21.3%) of 48 (55%) patients. Among 64 lesions for which the intended strategy was medical therapy, 16 (25%) were bypassed after disclosing FFR. The number of procedures with >1 venous graft planned was significantly reduced from 37 to 27 patients (p = .031). The proportion of on-pump surgery was significantly reduced from 71 to 61 patients (p = .006). The rates of clinical events at 1 year were similar between patients with or without at least one change in strategy. Discussion FFR-guided CABG is associated with a simplified surgical procedure in 55% of the patients, with similar clinical outcomes.