Coronary Heart Disease Diagnosis by FFRCT: Engineering Triumphs and Value Chain Analysis

Abstract

Coronary heart disease is the leading cause of death throughout the developed world, yet the symptoms that patients experience as a result of coronary disease are often not specific. Determining who are the minority of patients with myocardial ischemia necessitating revascularization is a major activity of many medical centers. This task has traditionally fallen to coronary angiography, which is an expensive and invasive approach to identifying coronary artery lesions necessitating treatment through revascularization with stents or bypass grafts. Recently, computational fluid dynamic methods have been developed for cardiac CT that have been shown to effectively exclude patients from an invasive test when they do not have significant coronary artery disease. This manuscript reviews the technique of CTFFR and discusses some of the challenges of widespread clinical implementation through value chain analysis. 25.1 Coronary Heart Disease Pathophysiology Development of coronary heart disease occurs over many years with atherosclerotic plaque deposition beginning in childhood and gradually progressing to a stage that can result in narrowing of the coronary arteries that may restrict blood flow to the heart muscle, particularly during high demand such as during exercise. Diminished