Utility of fractional flow reserve to determine treatment after recent large myocardial infarction with severe left ventricular dysfunction

Catheter Cardiovasc Interv. 2012 Nov 1;80(5):830-4. doi: 10.1002/ccd.23324. Epub 2012 Jan 10.

Abstract

Evaluation of ischemia and the extent of viable myocardium is required prior to consideration of revascularizing a lesion after a myocardial infarction in which there is hypo- or akinesis. We present a case in which we utilized fractional flow reserve (FFR) of a lesion in a patient whose nuclear study 7 days after infarction suggested minimal viability in the infarct zone. After FFR was positive, stenting was performed with recovery of a large amount of viable myocardium at 1 month as shown on nuclear study. This case illustrates that if ischemia is demonstrated by FFR in an infarct-related artery even with minimal viability by nuclear study, revascularization may result in significant myocardial recovery.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anterior Wall Myocardial Infarction / diagnosis*
  • Anterior Wall Myocardial Infarction / physiopathology
  • Anterior Wall Myocardial Infarction / therapy
  • Cardiac Catheterization*
  • Coronary Angiography
  • Fractional Flow Reserve, Myocardial*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods
  • Myocardium / pathology
  • Patient Selection
  • Percutaneous Coronary Intervention / instrumentation
  • Predictive Value of Tests
  • Recovery of Function
  • Stents
  • Time Factors
  • Tissue Survival
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Function, Left*