Clinical Utility of Fractional Flow Reserve on Computed Tomography in Left Main Trunk Disease

Abstract

normal left ventricular wall motion, while CCTA using a 320-row CT (Aquillion ONE, Toshiba Medical Systems, Ohtawara, Japan) showed severe stenosis in the distal left main trunk (LMT) bifurcation (Figure 1). In this case, adenosine 201 Tl-myocardial perfusion imaging (MPI) showed no apparent perfusion defects in the left coronary area on MPI/CT fusion image (Figure 1) with summed stress score 2, summed rest score 0, and no transient ischemic dilatation. The washout rate of the present patient for adenosine 201 Tl-myocardial perfusion image was 44.68% which was slightly lower than the normal washout rate of the present institution ( Figure S1). This indicated no myocardial ischemia. On FFRCT analysis, however, FFR of the H emodynamic assessment of coronary artery disease (CAD) is important for performing appropriate percutaneous coronary intervention (PCI). Fractional flow reserve on computed tomography (FFRCT) is a new technology provided by HeartFlow. This is an epoch-making analytical method that allows the data from standard coronary computed tomography angiography (CCTA) to yield hemodynamic assessment of CAD without invasive procedures. 1A 58-year-old woman with risk factors of type 2 diabetes mellitus and dyslipidemia developed chest discomfort on mild effort. Electrocardiography showed complete right bundle block, and ultrasound cardiography showed a IMAGES IN CARDIOVASCULAR MEDICINEAdvance Publication by-J-STAGE