title: Utility of fractional flow reserve to determine treatment after recent large myocardial infarction with severe left ventricular dysfunction.
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.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Sumith
authors.initials: S
authors.lastname: Aleti
authors.forename: Barry F
authors.initials: BF
authors.lastname: Uretsky
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sachdeva
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D009206:Myocardium / Q000473:pathology; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D020127:Recovery of Function; D015607:Stents; D013997:Time Factors; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left