Determination of fractional blood flow reserve (FFR)
Determination of the fractional blood flow reserve is an additional diagnostic method used during coronary angiography to decide whether coronary artery stenting or coronary artery bypass grafting is necessary if coronary angiography does not provide sufficient data.
Fractional blood flow reserve (FFR) determination is a diagnostic method used in coronary angiography. It presupposes measuring the difference in pressure after stenosis (distally) and the pressure before stenosis against the background of the administration of drugs (adenosine, papaverine) that expand the microcirculatory channel in the blood vessels of the heart. As a rule, it is used in the presence of stenoses in the coronary arteries (50-70%) in order to determine the probability of stenosis preventing the delivery of oxygen to the heart muscle causing ischemia in the myocardium. The result is an absolute number, FFR less than 0.80 means that the stenosis causes a 20% drop in blood pressure and causes ischemia in the myocardium, which requires revascularization (stenting or shunting).
How is it conducted?
It is carried out in the same way as coronary angiography, but in addition, a 0.014-inch conductor, which has pressure sensors on its surface, is introduced into the examined vessel. During the procedure, medication (adenosine or papaverine) is injected through the catheter which expands the microcirculatory channel in the vessels of the heart and can cause the feeling of hot flashes, interruptions in the work of the heart, dizziness (lasting 10-15 seconds). The patient is conscious and constantly interacts with the medical staff, who informs the patient about the probability of appearance of these sensations.
How to prepare?
Before the procedure, you will be examined by a cardiologist.
The doctor conducts
- electrocardiography (ECG),
- ultrasound examination of the heart (ECHO of the heart),
- laboratory tests (to determine the level of creatinine, urea, and other indicators if necessary).
Before determining the fractional blood flow reserve
- do not eat or drink coffee for 4-6 hours before the procedure,
- take all the medicines that you usually take.
Лікарі
Часті питання
- You can wear whatever you want when going to the hospital. During the procedure, you
- will be dressed in a hospital gown.
- Leave your valuables at home.
- One day before the arranged date, your doctor or nurse will tell you what you can and сan eat or drink before the procedure.
- Ask your doctor what medications you should take on the day of the procedure.
- Tell your doctor and/or nurses if you are allergic to anything.
- injected during the procedure.
- The procedure is performed in the X-ray operating room. This room is cool and dimly lit.
- You will lie on a special table above which you will see a large camera and several
- monitors.
- When the contrast medium is injected, you may feel heat or notice redness for a few
- seconds. This is normal – these sensations will quickly disappear.
- Catheters and an introducer are removed from the blood vessel. The doctor will press
- the puncture site with a finger and apply a compression bandage.
- The nurse will check your bandage regularly to prevent bleeding.
- After a puncture in the leg, you need to lie in bed for several hours.
- The puncture site may be sensitive.
- You will need to drink plenty of fluid to clear the contrast material from your body.
