Interv Akut Kardiol. 2009;8(5):264
More or less a disease of three coronary arteries and what next ?
- Interní kardiologická klinika FN a LF MU v Brně
Coronary artery disease despite its modern treatmen belongs to the main causes of mortality of the czech population. The optimal treatment
strategy should be based not just on the coronary disease morphology but also and especially on its functional significance. Coronary
angiography often does not provide enough information and the investigation should be followed by the functional testing, at least
in the borderline lesions (40 – 70 %). To perform the myocardial fractional flow reserve measurement just in the cathlab is besides the
non-invasive testing a very practical tool offered to the interventional cardiologist. This principle of this method is as follows: at physiological
conditions there is no pressure difference between aorta and epicardial coronary vessels. On the opposite the coronary stenosis
leads to the distal pressure drop invasively measured (1,0 means the normal value vs. less than 0,80 or even 0,75 means the significant
stenosis causes myocardial ischemia). The measurement has to be performed during maximal myocardial hyperemia provoked pharmacologically.
At present we should describe the coronary artery disease according to its angiographical and functional significance
indicating the potential revascularisation. In the case of coronary intervention (PCI) the final treatment consists from the drug-eluting
or bare-metal stent implantation. Here described videocase should demonstrate such a complex and relatively new approach.
Keywords: coronary artery disease, coronary intervention, coronary stent, myocardial fractional flow reserve.
Published: November 20, 2009 Show citation
