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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Fractional flow reserve measured via left internal mammary artery after coronary artery bypass grafting: Two case reports
Li-Ying Zhang, Yi-Rong Gan, Yan-Zhen Wang, Ding-Xiong Xie, Zong-Ke Kou, Xiao-Qing Kou, Yun-Long Zhang, Bing Li, Rui Mao, Tian-Xiang Liang, Jing Xie, Jian-Jian Jin, Jin-Mei Yang
Li-Ying Zhang, Yi-Rong Gan, Yan-Zhen Wang, Ding-Xiong Xie, Zong-Ke Kou, Xiao-Qing Kou, Yun-Long Zhang, Bing Li, Rui Mao, Tian-Xiang Liang, Gansu Institute of Cardiovascular Diseases, Lanzhou 730050, Gansu Province, China
Li-Ying Zhang, 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
Jing Xie, Jin-Mei Yang, Department of Functional, Lanzhou First People’s Hospital, Lanzhou 730050, Gansu Province, China
Jian-Jian Jin, Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Zhang LY, Gan YR and Wang YZ contributed equally to the study; Zhang LY, and Gan YR collected the cases and wrote the paper; Kou ZK and Kou XQ were responsible for surgical intervention; Zhang YL and Li B collected the data; Mao R was responsible for patient care; Liang TX was responsible for cardiopulmonary bypass; Xie J was responsible for clinical examination; Jin JJ analyzed the data; Xie DX, Wang YZ and Yang JM supervised the process, provided the financial support and revised the paper; All authors have read and approved the manuscript.
Supported by China Postdoctoral Science Foundation, No. 2021M693794; Health Key Science and Technology Development Project of Lanzhou, No. 2021006; Lanzhou Talent Innovation and Entrepreneurship Project, No. 2022-RC-51; and Gansu Province Double First-Class Scientific Research Key Project, No. GSSYLXM-05.
Informed consent statement: Informed written consents were obtained from the patients for publication of these two reports and any accompanying images.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article. The funders played no role in the study.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Jin-Mei Yang, MBBS, Associate Chief Physician, Department of Functional, Lanzhou First People’s Hospital, No. 1 Wujiayuan, Qilihe District, Lanzhou 730050, Gansu Province, China.
503490860@qq.com
Received: November 16, 2022
Peer-review started: November 16, 2022
First decision: January 12, 2023
Revised: February 15, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: May 6, 2023
Processing time: 160 Days and 2.9 Hours
BACKGROUND
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 via the left internal mammary artery (LIMA). Herein, we described the determination of further treatments by measuring FFR via the LIMA in 2 cases after coronary artery bypass grafting (CABG).
CASE SUMMARY
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 via 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 via 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.
CONCLUSION
We provided evidence that FFR measurement via grafted blood vessels, especially LIMA, after CABG is a good method to determine the intervention course.
Core Tip: We reported the determination of intervention by fractional flow reserve value measured via the left internal mammary artery after coronary artery bypass grafting in 2 cases. We provided evidence that fractional flow reserve measurement via grafted blood vessels, especially the left internal mammary artery, after coronary artery bypass grafting is a good method to determine whether to intervene.
