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Gepubliceerd in: Netherlands Heart Journal 7-8/2019

Open Access 08-07-2019 | Heart Beat

Coronary physiology assessment in a cardiac transplant patient

Auteurs: L. J. C. van Zandvoort, K. Masdjedi, M. N. Tovar Forero, O. Manintveld, J. Daemen

Gepubliceerd in: Netherlands Heart Journal | Uitgave 7-8/2019

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A 39-year-old male underwent coronary angiography 14 years after cardiac allograft transplantation revealing an intermediate grade stenosis in the mid left anterior descending artery (LAD) for which further physiological assessment was performed (Fig. 1). Subsequent pressure wire-based fraction flow reserve (FFRpw) was 0.87, suggesting a hemodynamically non-significant lesion. However, non-hyperaemic 3‑dimensional quantitative coronary angiography-based vessel fractional flow reserve (vFFR) was 0.74 (Fig. 1b). Given the discrepancies, optical coherence tomography was performed showing a fibrofatty plaque with a minimal lumen area (MLA) of 1.70mm2. The LAD was subsequently treated with a 3.0 × 15 mm stent. There has been ongoing debate on the validity of using FFR in denervated hearts due to high rates of microvascular dysfunction and an unreliable hyperaemic response [1]. Angiography based vFFR might be a promising new technology to study the hemodynamic significance of intermediate coronary artery lesions in denervated hearts [2].

Conflict of interest

L.J.C. van Zandvoort, K. Masdjedi, M.N. Tovar Forero, O. Manintveld and J. Daemen declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Literatuur
1.
go back to reference Hirohata A, Nakamura M, Waseda K, Honda Y, Lee DP, Vagelos RH, et al. Changes in coronary anatomy and physiology after heart transplantation. Am J Cardiol 2007;99(11):1603–7. CrossRefPubMedPubMedCentral Hirohata A, Nakamura M, Waseda K, Honda Y, Lee DP, Vagelos RH, et al. Changes in coronary anatomy and physiology after heart transplantation. Am J Cardiol 2007;99(11):1603–7. CrossRefPubMedPubMedCentral
Metagegevens
Titel
Coronary physiology assessment in a cardiac transplant patient
Auteurs
L. J. C. van Zandvoort
K. Masdjedi
M. N. Tovar Forero
O. Manintveld
J. Daemen
Publicatiedatum
08-07-2019
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 7-8/2019
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-019-1300-z

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