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Role of Invasive Functional Assessment in Surgical Revascularization of Coronary Artery Disease

Authors :
Yiannis S. Chatzizisis
Gregory Pavlides
Bipul Baibhav
Michael J. Moulton
Tanveer Rab
Maheedhar Gedela
George Dangas
Deepak L. Bhatt
Aleem Siddique
Vincent J. Pompili
Source :
Circulation. 137(16)
Publication Year :
2018

Abstract

In patients with stable coronary artery disease, percutaneous coronary intervention is associated with improved outcomes if the lesion is deemed significant by invasive functional assessment using fractional flow reserve. Recent studies have shown that a revascularization strategy using instantaneous wave-free ratio is noninferior to fractional flow reserve in patients with intermediate-grade stenoses. The decision to perform coronary artery bypass grafting surgery is usually based on anatomic assessment of stenosis severity by coronary angiography. The data on the role of invasive functional assessment in guiding surgical revascularization are limited. In this review, we discuss the diagnostic and prognostic significance of invasive functional assessment in patients considered for coronary artery bypass grafting. In addition, we critically discuss ongoing and future clinical trials on the role of invasive functional assessment in surgical revascularization.

Details

ISSN :
15244539
Volume :
137
Issue :
16
Database :
OpenAIRE
Journal :
Circulation
Accession number :
edsair.doi.dedup.....eac112a6ca5ed620480ca934170e35c0