Study of quantitative flow ratio-guided surgical coronary artery revascularization strategy
10.3760/cma.j.cn112434-20210125-00031
- VernacularTitle:定量血流分数指导冠状动脉外科血运重建手术策略的研究
- Author:
Cong CHEN
1
;
Yang ZHAO
;
Kui ZHANG
;
Pengyun YAN
;
Haiming DANG
;
Taoshuai LIU
;
Yue SONG
;
Jubing ZHENG
;
Yang LI
;
Lisong WU
;
Jian CAO
;
Ran DONG
Author Information
1. 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Keywords:
Quantitative flow ratio;
Coronary artery bypass grafting;
Fractional flow reserve
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(5):272-276
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility of applying quantitative flow ratio(QFR) to assess the degree of coronary artery functional stenosis before surgery, and to guide coronary artery bypass grafting(CABG) revascularization strategy.Methods:The study prospectively included a total of 154 patients who were electively treated with CABG in the 11th ward of the Department of Cardiac Surgery of Beijing Anzhen Hospital from January 2019 to September 2020, and their coronary angiography visually showed stenosis of the coronary artery to perform QFR analysis to know the diseased blood vessels. For functional stenosis, the surgeon was blinded to the results of QFR analysis before surgery. Collect its baseline data, perioperative data and recent clinical outcomes for summary analysis.Results:One year later, the coronary artery CTA showed that the occlusion rate of functionally significant disease(QFR<0.8) was 5.5%, and that of non-functionally significant disease(QFR≥0.8) was 15.6%. There was no difference in angina class or repeat interventions between patients with or without occluded bypass grafts.Conclusion:According to QFR analysis, coronary arteries with functional non-significant disease have a higher risk of grafts failure than those with functionally significant disease. For coronary arteries with negative QFR lesions, the risk of occlusion of arterial grafts is higher than that of venous. However, this finding is not significantly related to clinical prognosis, because patients with patency or occlusion of the grafts in non-significant lesions have not found excessive angina pectoris or repeated coronary interventions. QFR-guided selection of coronary surgery strategies is safe and feasible.
