title: Intraoperative Measurement of Fractional Flow Reserve in Off-Pump Coronary Artery Bypass: A Pilot Study.
abstract: BACKGROUND
  Fractional flow reserve of myocardium (FFRmyo) is a functional study of significant coronary artery stenosis, defined as the ratio of the pressure distal to the stenosis (poststenosis) divided by the pressure of aortic root (prestenosis). Instead of cath laboratory, we could measure it in operating room for off-pump coronary artery bypass (OPCAB) surgery and here shared our methods in the pilot study.
  
  
  RESULTS
  We used needles, catheters, and pressure tracing but without guidewires or fluoroscopy to measure FFRmyo during OPCAB. In February 2010, we conducted the pilot study and collected 32 anastomosis data from 10 patients. Without revising the anastomosis plans based on coronary angiographies, 24 FFRmyo of the 32 anastomoses (75%) were less than 0.75, which represented significant functional stenosis. The FFRmyo measurements did not lead to any adverse events.
  
  
  CONCLUSIONS
  The measurement of fractional flow reserve in OPCAB is safe and feasible. It can serve as a functional assessment of coronary artery stenosis in adjuvant to conventional coronary angiography.
authors.affiliation: Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Kuan-Ming
authors.initials: KM
authors.lastname: Chiu
authors.affiliation: Department of Anesthesiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Tzu-Yu
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Jer-Shen
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Jih-Hsin
authors.initials: JH
authors.lastname: Huang
authors.affiliation: Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Robert Jeen-Chen
authors.initials: RJ
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Shu-Hsun
authors.initials: SH
authors.lastname: Chu
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012720:Severity of Illness Index