Relationship between fractional flow reserve and graft patency after coronary artery bypass grafting

Michiko Ishida, Hiroshi Ishikawa, Yoshiyuki Takami, Kiyotoshi Akita, Kentaro Amano, Yusuke Sakurai, Mika Noda, Ryosuke Hayashi, Yasushi Takagi

研究成果: Article査読

抄録

Background: Bypass for moderately stenosed coronary arteries may cause graft failure (string phenomenon or occlusion). We examined the effects of fractional flow reserve (FFR) on the efficacy of coronary artery bypass grafting (CABG) in preventing graft failure. Methods: Between January 2013 and December 2017, 48 patients underwent CABG after FFR was measured. Twenty-five grafts in 23 patients were evaluated for graft patency after the procedure. We studied stenosis of native coronary arteries, FFR, graft flow, graft patency, and the presence of pre-procedure and post-procedure myocardial ischemia. Results: Three internal thoracic arteries showed the string sign, and two saphenous vein grafts showed occlusion. All target coronary arteries for these grafts had moderate (50–75%) stenosis. Of the 25 grafts, five failed, and 20 were successful. All grafts with the string sign had been bypassed for target coronary arteries with the gray-zone FFR value (0.75–0.80). No difference in graft flow was observed between the failed and successful grafts. Patients with graft failure had no postoperative myocardial ischemia in target areas despite graft condition. Conclusion: Internal thoracic artery graft for coronary arteries with the gray-zone FFR value may exhibit the string phenomenon. We believe that graft failure occurred because the target area had no ischemia before CABG. FFR is useful in pre-operative ischemic evaluation including scintigraphy and will influence the success of revascularization, including the selection of grafts.

本文言語English
ジャーナルGeneral Thoracic and Cardiovascular Surgery
DOI
出版ステータスAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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