Beyond the numbers: the challenge of FFR-guided strategies in multivessel disease undergoing CABG-think differently.

ABSTRACT:

Background

Fractional flow reserve (FFR) is a cornerstone in guiding percutaneous coronary intervention (PCI) for intermediate coronary lesions, supported by robust evidence and guidelines. Its application in coronary artery bypass grafting (CABG), however, remains uncertain, with no validated thresholds or standardized integration into surgical planning.

Case summary

We report the case of a 69-year-old man with three-vessel coronary artery disease who underwent total arterial revascularization using a bilateral internal mammary artery Y-graft. Despite a pre-operative FFR of 0.78 in the left anterior descending artery (LAD), intra-operative transit-time flow measurements revealed severely impaired graft flow, prompting revision of the left internal mammary artery-LAD anastom

SUBMITTER: Ferraro F 

PROVIDER: S-EPMC12582221 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature