Page 225 - Read Online

Van der Merwe et al. Vessel Plus 2019;3:24 Vessel Plus
DOI: 10.20517/2574-1209.2019.17

Review Open Access

Fractional flow reserve guided coronary artery
bypass grafting - new developments and future

perspectives

Johan Van der Merwe, Filip Casselman

Department of Cardiovascular- and Thoracic Surgery OLV Clinic, Aalst, Moorselbaan 164 9300, Belgium.
Correspondence to: Dr. Filip Casselman, Department of Cardiovascular- and Thoracic Surgery OLV Clinic, Aalst, Moorselbaan
164 9300, Belgium. E-mail: filip.casselman@olvz-aalst.be
How to cite this article: Van der Merwe J, Casselman F. Fractional flow reserve guided coronary artery bypass grafting - new
developments and future perspectives. Vessel Plus 2019;3:24. http://dx.doi.org/10.20517/2574-1209.2019.17
Received: 26 May 2019 First Decision: 21 Jun 2019 Revised: 2 Jul 2019 Accepted: 4 Jul 2019 Published: 20 Jul 2019

Science Editor: Mario F. L. Gaudino Copy Editor: Jia-Jia Meng Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published: x
The potential role of fractional flow reserve (FFR) in coronary artery bypass grafting (CABG) planning and post-
Science Editor: Copy Editor: Production Editor: Jing Yu
CABG patency assessment are currently under intense investigation to determine whether the favourable outcomes
reported with FFR-guided percutaneous coronary intervention can be translated to surgical practice. This review
provides an overview of the principles that guide FFR measurement, the clinical evolution of FFR in CABG practice,
the much anticipated outcomes of recent investigations that compare FFR-guided and angiography guided CABG
and outlines the potential of alternative technology that may assist in ensuring ongoing improvement in surgical
revascularization outcomes.

Keywords: Coronary artery bypass grafting, percutaneous coronary intervention, fractional flow reserve, outcomes

INTRODUCTION
We are currently witnessing rapid evolution in diagnostic and interventional technology for coronary
artery disease (CAD). It is now well recognized that the visual assessment of coronary artery stenosis
[1]
by angiography or intravascular ultrasound [2,3] do not accurately reflect its physiological impact on
myocardial territory. Fractional flow reserve (FFR) emerged as a transcatheter tool to potentially quantify
the physiological significance of coronary artery stenosis and various reports over the last 2 decades
[4,5]
repeatedly confirmed the favorable impact of FFR on percutaneous coronary intervention (PCI) decision-

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.vpjournal.net