Should Fractional Flow Reserve Testing Be Routinely Utilized to Guide Bypass Grafting?

The answer appears to be no, based on this small study.

Fractional flow reserve (FFR) testing has established value for patients undergoing percutaneous coronary intervention (PCI), but most decisions for revascularization by coronary-artery bypass grafting (CABG) use visual assessments of stenosis severity. Some studies have suggested improved graft patency to vessels with more severe stenoses as determined by FFR. In a prospective, randomized, open-label trial (NCT02477371), researchers compared graft patency and clinical outcomes after FFR-guided CABG versus angiography-guided CABG in 97 patients.

In the FFR-guided group, only lesions with FFR ≤0.8 were planned for grafting. The angiography-guided group received FFR testing, but surgeons were blinded to the measurements. Fewer grafts per patie…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)