The role of fractional flow reserve in determining tactics of revascularization in patients with ischemic heart disease
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Abstract
In the light of the latest technologies, it is impossible to imagine the development of medicine and, in particular, cardiac surgery, without the use of minimally invasive treatments. Endovascular revascularization interventions have been used for over 20 years, and today they have become the «gold» standard for a number of coronary lesions. This review presents a large number of studies and evidence confirming the use of measuring the physiological parameters of coronary blood flow (fractional flow reserve) for the treatment of chronic coronary heart disease and the possibility of their use in acute coronary syndrome. In addition, there is evidence of the use of the method of instantaneous wave-free ratio, which is carried out without the use of vasodilators, thus eliminating their side effects. Despite the high informativeness and reliability of the fractional flow reserve methodology, its use is insufficient in clinics in Ukraine and the world as a whole. This technique is used to determine significant hemodynamic changes in the blood supply to the myocardium in the so-called «intermediate stenosis» of the coronary artery. Determining fractional flow reserve is a fairly simple and affordable method of diagnosis and, consequently, the correct treatment of coronary heart disease. The introduction of fractional flow reserve in routine practice will not only change the quantitative side of cardiac surgery and endovascular interventions, but also improve the quality of life of patients and reduce the economic costs of coronary heart disease treatment.
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