Fractional Flow Reserve in the Diagnosis of Ischemic Heart Disease in a Patient with Coronary Artery Ectasia.

Malgorzata Zalewska-Adamiec,Slawomir Dobrzycki,Hanna Bachorzewska-Gajewska,Lukasz Kuzma

doi:10.3390/diagnostics12010017

Malgorzata Zalewska-Adamiec, Slawomir Dobrzycki + Show 2 more

Open Access

https://doi.org/10.3390/diagnostics12010017

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Journal: Diagnostics	Publication Date: Dec 23, 2021
License type: CC BY 4.0

Affiliation: Medical University of Białystok

Abstract

Coronary artery ectasias (CAE) are diffuse dilatations of coronary artery segments with a diameter 1.5 times greater than the largest adjacent normal segment of the vessel. They are found in 0.3–5.0% of coronary angiography. Risk factors for CAE include atherosclerosis, previous percutaneous coronary interventions, arterial inflammation and connective tissue diseases. The diagnosis of CEA in a patient is a considerable diagnostic and therapeutic problem due to the unfavorable prognosis and the lack of guidelines. We present a case of a 69-year-old male patient with a history of retrosternal pain admitted to the clinic for the diagnosis of coronary artery disease. In coronary angiography, numerous ectases of the main coronary arteries and atherosclerotic lesions causing border stenosis of the left anterior descending (LAD), diagonal (2D) and marginal branch (OM). The heart team decided to assess the significance of the changes with the fractional flow reserve (FFR). The FFR was performed and haemodynamically insignificant stenoses of the ectatically dilated coronary arteries were found. The patient was qualified for conservative treatment.

Highlights

Diagnostics 2022, 12, 17 clinic for invasive diagnosis
The patient underwent coronary angiography which showed numerous ectasias of the coronary arteries with atherosclerotic lesions; LAD ectatically widened to half its length with 50% stenosis in the middle segment, 70% stenosis in the mouth of 2D, Cx ectatically altered along its entire length, 1OM ectatically widened with 75% stenosis in the distal segment and RCA changed ectatically to half length (A,B)
The heart team qualified the patient for the assessment of the significance of stenoses in LAD and 2D by FFR

Summary

Introduction

Diagnostics 2022, 12, 17 clinic for invasive diagnosis. The patient underwent coronary angiography which showed numerous ectasias of the coronary arteries with atherosclerotic lesions; LAD ectatically widened to half its length with 50% stenosis in the middle segment (white arrow), 70% stenosis in the mouth of 2D (red arrow), Cx (circumflex artery) ectatically altered along its entire length, 1OM ectatically widened with 75% stenosis in the distal segment (green arrow) and RCA (right coronary artery) changed ectatically to half length (A,B). Diagnostics 2022, 12, 17 clinic for invasive diagnosis. The patient underwent coronary angiography which showed numerous ectasias of the coronary arteries with atherosclerotic lesions; LAD ectatically widened to half its length with 50% stenosis in the middle segment (white arrow), 70% stenosis in the mouth of 2D (red arrow), Cx (circumflex artery) ectatically altered along its entire length, 1OM ectatically widened with 75% stenosis in the distal segment (green arrow) and RCA (right coronary artery) changed ectatically to half length (A,B).

Results

Conclusion