Zhang Li-Ying, Gan Yi-Rong, Wang Yan-Zhen, Xie Ding-Xiong, Kou Zong-Ke, Kou Xiao-Qing, Zhang Yun-Long, Li Bing, Mao Rui, Liang Tian-Xiang, Xie Jing, Jin Jian-Jian, Yang Jin-Mei
Gansu Institute of Cardiovascular Diseases, Lanzhou 730050, Gansu Province, China.
Provincial Level Key Laboratory for Molecular Medicine of Major Diseases and Prevention and Treatment with Traditional Chinese Medicine Research in Gansu Colleges and Universities, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China.
World J Clin Cases. 2023 May 6;11(13):3045-3051. doi: 10.12998/wjcc.v11.i13.3045.
The fractional flow reserve (FFR) has made the treatment of coronary heart disease more precise. However, there are few reports on the measurement of FFR the left internal mammary artery (LIMA). Herein, we described the determination of further treatments by measuring FFR the LIMA in 2 cases after coronary artery bypass grafting (CABG).
Case 1 was a 66-year-old male who was admitted due to "chest tightness after CABG." The patient underwent CABG 7 years prior due to coronary heart disease. Coronary artery angiography showed complete occlusion of the left anterior descending artery (LAD), and subtotal occlusion of the third segment of the right coronary artery. On arterial angiography, there was 85% stenosis at the distal end of the anastomosis of the LIMA-LAD graft. FFR LIMA was determined at 0.75. Thus, balloon dilation was performed in Case 1. FFR after balloon dilation was 0.94. Case 2 was a 60-year-old male who was admitted due to "chest tightness after CABG." The patient underwent CABG 6 years prior due to coronary heart disease. There was 60% segmental stenosis in the middle segment of LAD and 75% anastomotic stenosis. FFR measured LIMA was 0.83 (negative); thus the intervention was not performed. Case 2 was given drug treatments. At the 3-mo follow-up, there was no recurrence of chest tightness or shortness of breath in both cases. They are currently under continual follow-up.
We provided evidence that FFR measurement grafted blood vessels, especially LIMA, after CABG is a good method to determine the intervention course.
血流储备分数（FFR）使冠心病的治疗更加精准。然而，关于测量左乳内动脉（LIMA）的FFR的报道较少。在此，我们描述了通过测量冠状动脉旁路移植术（CABG）后2例患者LIMA的FFR来确定进一步治疗方案的情况。
病例1是一名66岁男性，因“CABG术后胸闷”入院。该患者7年前因冠心病接受CABG手术。冠状动脉造影显示左前降支动脉（LAD）完全闭塞，右冠状动脉第三段次全闭塞。在动脉造影中，LIMA-LAD移植血管吻合口远端有85%的狭窄。LIMA的FFR测定为0.75。因此，对病例1进行了球囊扩张。球囊扩张后的FFR为0.94。病例2是一名60岁男性，因“CABG术后胸闷”入院。该患者6年前因冠心病接受CABG手术。LAD中段有60%的节段性狭窄，吻合口狭窄75%。测量的LIMA的FFR为0.83（阴性）；因此未进行干预。病例2接受了药物治疗。在3个月的随访中，两例患者均无胸闷或气短复发。他们目前正在持续随访中。
我们提供了证据表明，CABG术后测量移植血管，尤其是LIMA的FFR是确定干预方案的一种好方法。
