Tips and tick for left main PCI integrated use of FFR and IVUS

Tips and Tick for Left Main PCI Integrated Use of FFR and IVUS Seung-Jung Park, MD, PhD Professor of Medicine, University of Ulsan College of Medicine Heart Institute, Asan Medical Center, Seoul, Korea Q1, Why FFR ? Visual Functional Mismatch Visual : 80% FFR : 0.82 Treadmill test : Negative Thallium spect : Normal Stress Echo : Negative Reverse Mismatch Visual Estimation : 30% FFR : 0.70 IVUS MLA: 6.2 mm2 Treadmill test: + stage Thallium spect : + large LAD How Many Mismatches ? Mismatches Intermediate LM Disease, Overall 29% % Diameter Stenosis 80 6% 60 40 v 20 23% R=-0.38, p[...].. .FFR Is Determined By, • Reference vessel diameter (myocardium) FFR Is Anatomical and influenced • Many lesion specific local factors Functional Integration of Stenosis the value of FFR “Total Lesion Perception” Park SJ et al, JACC Intv 2012;5:1029 –36 Validation with FFR Non-invasive Stress Test Results (n=45 patients, intravenous adenosine infusion) FFR