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Journal of Structural Heart Disease, December 2018, Volume 4, Issue 6:254-257
DOI: 10.12945/j.jshd.2019.005.18
Use of FFRCT for Evaluation of Left Main Stenosis in a Patient Considered for TAVR
Travis Tagami, DO, Robert D. Safian, MD*, Elvis Cami, MD
Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan, USA
Abstract
A 91-year-old male with coronary artery disease (CAD) and aortic stenosis presented with three months of dyspnea on exertion; he was referred for possible transcatheter aortic valve replacement (TAVR). An echo demonstrated a normal ejection fraction, aortic peak velocity of 3.8 m/sec, mean gradient of 32 mmHg, and a calculated aortic valve area of .41 cm2. Coronary angiography demonstrated 70% stenosis in the distal left main coronary artery (LMCA) extending into the bifurcation, and severe disease in the mid left circumflex artery. There was disagreement about the severity of the LMCA stenosis, so fractional flow reserve-computed tomography (FFRCT) was performed. The FFRct was 0.66 in the proximal left anterior descending and 0.68 in the proximal left circumflex, suggesting hemodynamically significant LMCA stenosis. He underwent surgical aortic valve replacement and coronary artery bypass graft surgery. FFRCT can be useful for identifying hemodynamically significant CAD and guide decisions about revascularization.
Cite this article as: Tagami T, Safian R, Cami E. Use of FFRCT for Evaluation of Left Main Stenosis in a Patient Considered for TAVR. Structural Heart Disease 2018;4(6):254-257. DOI: 10.12945/j.jshd.2019.005.18
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Case Studies
Journal of Structural Heart Disease, December 2018, Volume 4, Issue 6:254-257
DOI: 10.12945/j.jshd.2019.005.18
Use of FFRCT for Evaluation of Left Main Stenosis in a Patient Considered for TAVR
Travis Tagami, DO, Robert D. Safian, MD*, Elvis Cami, MD
Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan, USA
Abstract
A 91-year-old male with coronary artery disease (CAD) and aortic stenosis presented with three months of dyspnea on exertion; he was referred for possible transcatheter aortic valve replacement (TAVR). An echo demonstrated a normal ejection fraction, aortic peak velocity of 3.8 m/sec, mean gradient of 32 mmHg, and a calculated aortic valve area of .41 cm2. Coronary angiography demonstrated 70% stenosis in the distal left main coronary artery (LMCA) extending into the bifurcation, and severe disease in the mid left circumflex artery. There was disagreement about the severity of the LMCA stenosis, so fractional flow reserve-computed tomography (FFRCT) was performed. The FFRct was 0.66 in the proximal left anterior descending and 0.68 in the proximal left circumflex, suggesting hemodynamically significant LMCA stenosis. He underwent surgical aortic valve replacement and coronary artery bypass graft surgery. FFRCT can be useful for identifying hemodynamically significant CAD and guide decisions about revascularization.
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Cite this article as: Tagami T, Safian R, Cami E. Use of FFRCT for Evaluation of Left Main Stenosis in a Patient Considered for TAVR. Structural Heart Disease 2018;4(6):254-257. DOI: 10.12945/j.jshd.2019.005.18
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