Pressure Recovery in the Left Main Stenosis

Jesper Møller Jensen, Hans Erik Bøtker, Niels Peter Sand, Bjarne Linde Nørgaard

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Abstract

A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.

Original languageEnglish
Article number39
JournalJournal of Clinical Imaging Science
Volume9
Number of pages4
ISSN2156-7514
DOIs
Publication statusPublished - 2. Aug 2019

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Pathologic Constriction
Coronary Angiography
Coronary Artery Disease
Computed Tomography Angiography

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Jensen, Jesper Møller ; Bøtker, Hans Erik ; Sand, Niels Peter ; Nørgaard, Bjarne Linde. / Pressure Recovery in the Left Main Stenosis. In: Journal of Clinical Imaging Science. 2019 ; Vol. 9.
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title = "Pressure Recovery in the Left Main Stenosis",
abstract = "A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.",
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Pressure Recovery in the Left Main Stenosis. / Jensen, Jesper Møller; Bøtker, Hans Erik; Sand, Niels Peter; Nørgaard, Bjarne Linde.

In: Journal of Clinical Imaging Science, Vol. 9, 39, 02.08.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Pressure Recovery in the Left Main Stenosis

AU - Jensen, Jesper Møller

AU - Bøtker, Hans Erik

AU - Sand, Niels Peter

AU - Nørgaard, Bjarne Linde

PY - 2019/8/2

Y1 - 2019/8/2

N2 - A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.

AB - A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.

U2 - 10.25259/JCIS_40_2019

DO - 10.25259/JCIS_40_2019

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