Changes in Surgical Revascularization Strategy After Fractional Flow Reserve
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4833 |
Resumo: | Aims: In the randomized GRAFFITI trial, surgeons drew their strategy based on coronary angiography. When patients were randomized to fractional flow reserve (FFR)-guidance, surgeons were informed of the FFR values and asked to redraw their strategy. The aim of this study was to investigate the changes induced by FFR knowledge. Methods and results: The intended and performed strategy (before and after FFR) were compared. Among 172 patients, 84 with 300 lesions were randomized to the FFR-guided group. The intended strategy was to bypass 236 stenoses:108 with a venous and 128 with an arterial graft. After disclosing FFR, a change in strategy occurred in 64 lesions (21.3%) of 48 (55%) patients. Among 64 lesions for which the intended strategy was medical therapy, 16 (25%) were bypassed after disclosing FFR. The number of procedures with >1 venous graft planned was significantly reduced from 37 to 27 patients (p = .031). The proportion of on-pump surgery was significantly reduced from 71 to 61 patients (p = .006). The rates of clinical events at 1 year were similar between patients with or without at least one change in strategy. Discussion: FFR-guided CABG is associated with a simplified surgical procedure in 55% of the patients, with similar clinical outcomes. |
id |
RCAP_b3e70bd48a54e1168afbdff4947556c6 |
---|---|
oai_identifier_str |
oai:repositorio.chlc.min-saude.pt:10400.17/4833 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Changes in Surgical Revascularization Strategy After Fractional Flow ReserveHSM CARCoronary AngiographyHumansTreatment OutcomeCoronary Artery Bypass / adverse effectsCoronary Artery Disease* / diagnostic imagingCoronary Artery Disease* / surgeryCoronary Stenosis* / diagnostic imagingCoronary Stenosis* / surgeryFollow-Up StudiesFractional Flow Reserve, Myocardial*Aims: In the randomized GRAFFITI trial, surgeons drew their strategy based on coronary angiography. When patients were randomized to fractional flow reserve (FFR)-guidance, surgeons were informed of the FFR values and asked to redraw their strategy. The aim of this study was to investigate the changes induced by FFR knowledge. Methods and results: The intended and performed strategy (before and after FFR) were compared. Among 172 patients, 84 with 300 lesions were randomized to the FFR-guided group. The intended strategy was to bypass 236 stenoses:108 with a venous and 128 with an arterial graft. After disclosing FFR, a change in strategy occurred in 64 lesions (21.3%) of 48 (55%) patients. Among 64 lesions for which the intended strategy was medical therapy, 16 (25%) were bypassed after disclosing FFR. The number of procedures with >1 venous graft planned was significantly reduced from 37 to 27 patients (p = .031). The proportion of on-pump surgery was significantly reduced from 71 to 61 patients (p = .006). The rates of clinical events at 1 year were similar between patients with or without at least one change in strategy. Discussion: FFR-guided CABG is associated with a simplified surgical procedure in 55% of the patients, with similar clinical outcomes.WileyRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEFournier, SToth, GDe Bruyne, BKala, PRibichini, FCasselman, FRamos, RPiroth, ZPiccoli, APenicka, MMates, MNemec, PVan Praet, FStockman, BDegriek, IPellicano, MBarbato, E2024-03-08T16:16:25Z20212021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4833engCatheter Cardiovasc Interv . 2021 Sep;98(3):E351-E355.10.1002/ccd.29694info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-10T06:26:18Zoai:repositorio.chlc.min-saude.pt:10400.17/4833Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:14:22.939489Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
title |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
spellingShingle |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve Fournier, S HSM CAR Coronary Angiography Humans Treatment Outcome Coronary Artery Bypass / adverse effects Coronary Artery Disease* / diagnostic imaging Coronary Artery Disease* / surgery Coronary Stenosis* / diagnostic imaging Coronary Stenosis* / surgery Follow-Up Studies Fractional Flow Reserve, Myocardial* |
title_short |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
title_full |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
title_fullStr |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
title_full_unstemmed |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
title_sort |
Changes in Surgical Revascularization Strategy After Fractional Flow Reserve |
author |
Fournier, S |
author_facet |
Fournier, S Toth, G De Bruyne, B Kala, P Ribichini, F Casselman, F Ramos, R Piroth, Z Piccoli, A Penicka, M Mates, M Nemec, P Van Praet, F Stockman, B Degriek, I Pellicano, M Barbato, E |
author_role |
author |
author2 |
Toth, G De Bruyne, B Kala, P Ribichini, F Casselman, F Ramos, R Piroth, Z Piccoli, A Penicka, M Mates, M Nemec, P Van Praet, F Stockman, B Degriek, I Pellicano, M Barbato, E |
author2_role |
author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Fournier, S Toth, G De Bruyne, B Kala, P Ribichini, F Casselman, F Ramos, R Piroth, Z Piccoli, A Penicka, M Mates, M Nemec, P Van Praet, F Stockman, B Degriek, I Pellicano, M Barbato, E |
dc.subject.por.fl_str_mv |
HSM CAR Coronary Angiography Humans Treatment Outcome Coronary Artery Bypass / adverse effects Coronary Artery Disease* / diagnostic imaging Coronary Artery Disease* / surgery Coronary Stenosis* / diagnostic imaging Coronary Stenosis* / surgery Follow-Up Studies Fractional Flow Reserve, Myocardial* |
topic |
HSM CAR Coronary Angiography Humans Treatment Outcome Coronary Artery Bypass / adverse effects Coronary Artery Disease* / diagnostic imaging Coronary Artery Disease* / surgery Coronary Stenosis* / diagnostic imaging Coronary Stenosis* / surgery Follow-Up Studies Fractional Flow Reserve, Myocardial* |
description |
Aims: In the randomized GRAFFITI trial, surgeons drew their strategy based on coronary angiography. When patients were randomized to fractional flow reserve (FFR)-guidance, surgeons were informed of the FFR values and asked to redraw their strategy. The aim of this study was to investigate the changes induced by FFR knowledge. Methods and results: The intended and performed strategy (before and after FFR) were compared. Among 172 patients, 84 with 300 lesions were randomized to the FFR-guided group. The intended strategy was to bypass 236 stenoses:108 with a venous and 128 with an arterial graft. After disclosing FFR, a change in strategy occurred in 64 lesions (21.3%) of 48 (55%) patients. Among 64 lesions for which the intended strategy was medical therapy, 16 (25%) were bypassed after disclosing FFR. The number of procedures with >1 venous graft planned was significantly reduced from 37 to 27 patients (p = .031). The proportion of on-pump surgery was significantly reduced from 71 to 61 patients (p = .006). The rates of clinical events at 1 year were similar between patients with or without at least one change in strategy. Discussion: FFR-guided CABG is associated with a simplified surgical procedure in 55% of the patients, with similar clinical outcomes. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021 2021-01-01T00:00:00Z 2024-03-08T16:16:25Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4833 |
url |
http://hdl.handle.net/10400.17/4833 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Catheter Cardiovasc Interv . 2021 Sep;98(3):E351-E355. 10.1002/ccd.29694 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Wiley |
publisher.none.fl_str_mv |
Wiley |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137796943773696 |