Exploring the relationship between distal coronary fractional flow reserve derived from aortic CTA and intraoperative graft flow in off-pump coronary artery bypass graft
10.3760/cma.j.cn112434-20241209-00310
- VernacularTitle:基于主动脉CTA的冠状动脉远端血流储备分数与OPCABG术中旁路移植血管流量关系的探讨
- Author:
Yilin LI
1
;
Yuan XUE
1
;
Shipan WANG
1
;
Zhiran YANG
1
;
Haiyang LI
1
Author Information
1. 北京市心肺血管疾病研究所 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass grafting;
CTA-derived fractional flow reserve;
Graft flow;
Aortic computed tomography angiography
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(9):550-555
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the distal fractional flow reserve(FFR-CT) of the left anterior descending artery(LAD) measured by aortic CTA and the intraoperative left internal mammary artery(LIMA-LAD) graft flow during off-pump coronary artery bypass grafting(OPCABG). And to evaluate the role of FFR-CT in predicting intraoperative flow characteristics, competitive flow, and diffuse coronary lesions.Methods:Retrospectively included 162 OPCABG patients who underwent LIMA-LAD grafting. The primary outcome was the average flow value(Qm) of the LIMA-LAD graft measured intraoperatively. Smooth curve fitting and linear regression analysis were used to explore the relationship between preoperative LAD distal FFR-CT values and the intraoperative LIMA-LAD graft flow Qm.Results:Group analysis showed that Qm significantly decreased as the distal FFR-CT values increased. Smooth curve fitting revealed a " reverse U-shaped" relationship between LAD distal FFR-CT and Qm. When the FFR-CT value>0.64, Qm demonstrated a significant negative linear correlation with FFR-CT(regression coefficient β=-178.6432, P=0.004). Conclusion:A distal FFR-CT value of >0.64 in the LAD may increase the risk of competitive flow in the LIMA-LAD graft, while excessively low FFR-CT values likely reflect diffuse coronary lesions, leading to a reduction in graft flow.
