Utility of fractional flow reserve to determine treatment after recent large myocardial infarction with severe left ventricular dysfunction

作者：Aleti Sumith; Uretsky Barry F; Sachdeva Rajesh^*

来源：Catheterization and Cardiovascular Interventions, 2012, 80(5): 830-834.

DOI：10.1002/ccd.23324

• fractional flow reserve
• myocardial infarction
• myocardial viability
• percutaneous coronary intervention
• angioplasty
• nuclear stress testing

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.