Pressure Recovery in the Left Main Stenosis

Jesper Møller Jensen, Hans Erik Bøtker, Niels Peter Rønnow Sand, Bjarne Linde Nørgaard

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Abstract

A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.

Original languageEnglish
Article number39
JournalJournal of Clinical Imaging Science
Volume9
ISSN2156-7514
DOIs
Publication statusPublished - 2019

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