Hemodynamic impact of different forms of anomalous coronary connection using Computed Tomography derived Fractional Flow Reserve (FFRCT) - 25/12/18
Résumé |
Introduction |
Computed Tomography derived Fractional Flow Reserve (FFRCT) is a non-invasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features could help to tackle difficult decisions in patients presenting anomalous coronary connection (ANOCOR).
Purpose |
We aimed to evaluate the hemodynamic impact of different types of ANOCOR using FFRCT in a large cohort of patients.
Methods |
Adult patients with ANOCOR detected during coronary angiogram or computed tomography (CT) were included in the multi-centric ANOCOR registry. Hundred and six patients were evaluated between 2009 and 2012 with a coronary CT at the time of inclusion. Patients with coronary artery connection from the pulmonary arterial trunk were excluded from the analysis.
Results |
FFRCT values could be calculated in 60 patients. Mean age of patients was 58±14 years, 47 (78%) were male. Preaortic, retroaortic, subpulmonar and prepulmonar courses were observed respectively in 34 (53%), 16 (27%), 6 (8%) and 4 (8%) patients. Mean FFR values were 0.82±0.11 in preaortic, 0.85±0.08 in retroaortic, 0.81±0.16 in subpulmonar, and 0.83±0.12 in prepulmonar courses. No statistical difference was observed between courses (P>0.05). The ANOCOR involved the left main/left anterior descending (LM/LAD) in 10 patients (17%), the left circumflex (LCx) in 11 patients (18%) and the right coronary artery (RCA) in 39 patients (65%). In ANOCOR vessels, mean FFR values in LM/LAD, LCx and RCA were respectively 0.81±0.13, 0.81±0.12 and 0.83±0.11 (P>0.5 for all). FFRCT analysis showed mean FFR value downstream the ANOCOR was 0.90±0.09. In the distal part of ANOCOR vessels mean FFR value was significantly lower compared to non ANOCOR vessel respectively 0.83±0.10 versus 0.87±0.09 (P=0.0003) (Fig. 1).
Conclusions |
The hemodynamic impact of different forms of ANOCOR measured with FFRCT showed majority of values above 0.80 in ANOCOR and non ANOCOR vessels.
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Vol 11 - N° 1
P. 8 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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