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Potential influence of invisible coronary collateral circulation on fractional flow reserve of donor artery in the presence of severe stenosis of receiving artery

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Abstract

We reported a case of 78-year-old male who had a severe stenosis in the right coronary artery (RCA) and an intermediate stenosis in the left anterior descending artery (LAD) without visible collateral flow to the RCA on angiogram. Fractional flow reserve (FFR) in the LAD lesion, which revealed significant value as 0.70, increased to 0.78 after revascularization of the RCA lesion. The FFR in an intermediate stenosis should be performed after PCI for severe stenosis in the other coronary arteries. Otherwise, the severity of the stenosis could be overestimated due to the presence of invisible collateral circulation.

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References

  1. Pijls NH, De Bruyne B, Peels K, Van Der Voort PH, Bonnier HJ, Bartunek J, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med. 1996;334:1703–8.

    Article  CAS  PubMed  Google Scholar 

  2. Peelukhana SV, Kolli KK, Leesar MA, Effat MA, Helmy TA, Arif I, et al. Effect of myocardial contractility on hemodynamic end points under concomitant microvascular disease in a porcine model. Heart Vessels. 2014;29:97–109.

    Article  PubMed  Google Scholar 

  3. De Bruyne B, Sarma J. Fractional flow reserve: a review: invasive imaging. Heart. 2008;94:949–59.

    Article  PubMed  Google Scholar 

  4. De Bruyne B, Pijls NH, Heyndrickx GR, Hodeige D, Kirkeeide R, Gould KL. Pressure-derived fractional flow reserve to assess serial epicardial stenoses: theoretical basis and animal validation. Circulation. 2000;101:1840–7.

    Article  PubMed  Google Scholar 

  5. Vanoverschelde JL, Wijns W, Depre C, Essamri B, Heyndrickx GR, Borgers M, et al. Mechanisms of chronic regional postischemic dysfunction in humans: new insights from the study of noninfarcted collateral-dependent myocardium. Circulation. 1993;87:1513–23.

    Article  CAS  PubMed  Google Scholar 

  6. Kurisu S, Mitsuba N, Ishibashi K, Kato Y, Dohi Y, Nishioka K, et al. A pitfall of fractional flow reserve associated with the presence of collateral circulation. Intern Med. 2011;50:2811–3.

    Article  PubMed  Google Scholar 

  7. Iqbal MB, Shah N, Khan M, Wallis W. Reduction in myocardial perfusion territory and its effect on the physiological severity of a coronary stenosis. Circ Cardiovasc Interv. 2010;3:89–90.

    Article  PubMed  Google Scholar 

  8. Pijls NH, Bech GJ, el Gamal MI, Bonnier HJ, De Bruyne B, Van Gelder B, et al. Quantification of recruitable coronary collateral blood conscious humans and its potential to predict future ischemic events. J Am Coll Cardiol. 1995;25:1522–8.

    Article  CAS  PubMed  Google Scholar 

  9. Rockstroh J, Brown BG. Coronary collateral size, flow capacity, and growth: estimates from the angiogram in patients with obstructive coronary disease. Circulation. 2002;105:168–73.

    Article  PubMed  Google Scholar 

  10. Nomura T, Kusaba T, Kodama N, Terada K, Urakabe Y, Nishikawa S, et al. Clinical characteristics of silent myocardial ischemia diagnosed with adenosine stress 99m Tc-tetrofosmin myocardial scintigraphy in Japanese patients with acute cerebral infarction. Heart Vessels. 2013;28:27–33.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan

    Hiroto Tamaru, Kenichi Fujii, Masashi Fukunaga, Takahiro Imanaka, Kojiro Miki, Daizo Kawasaki & Tohru Masuyama

  2. Division of Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan

    Motomaru Masutani & Mitsumasa Ohyanagi

Authors
  1. Hiroto Tamaru
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  2. Kenichi Fujii
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  3. Masashi Fukunaga
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  4. Takahiro Imanaka
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  5. Kojiro Miki
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  6. Daizo Kawasaki
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  7. Motomaru Masutani
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  8. Mitsumasa Ohyanagi
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  9. Tohru Masuyama
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Correspondence to Kenichi Fujii.

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Tamaru, H., Fujii, K., Fukunaga, M. et al. Potential influence of invisible coronary collateral circulation on fractional flow reserve of donor artery in the presence of severe stenosis of receiving artery. Cardiovasc Interv and Ther 30, 266–269 (2015). https://doi.org/10.1007/s12928-014-0275-3

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  • DOI: https://doi.org/10.1007/s12928-014-0275-3

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