Invasive coronary angiography has been the preferred diagnostic method to guide the decision-making process between coronary artery bypass grafting (CABG) and percutaneous coronary intervention and plan a surgical revascularization procedure. Guidelines recommend a heart team approach and assessment of coronary artery disease (CAD) complexity, objectively quantified by the anatomical SYNTAX score. Coronary computed tomography angiography (CCTA) and CT-derived fractional flow reserve (FFRCT) are emerging technologies in the diagnosis of stable CAD. In this study, data from patients with left main or 3-vessel CAD who underwent CABG were evaluated to assess the feasibility of developing a surgical plan based on CCTA integrated with FFRCT. The primary objective was to assess the theoretical feasibility of surgical decision-making and treatment planning based only on non-invasive imaging.
Sonck J, Miyazaki Y, Collet C, Onuma Y, Asano T, Takahashi K, Kogame N, Katagiri Y, Modolo R, Serruys PW, Bartorelli AL, Andreini D, Doenst T, Maureira JP, Plass A, La Meir M, Pompillio G. Feasibility of planning coronary artery bypass grafting based only on coronary computed tomography angiography and CT-derived fractional flow reserve: a pilot survey of the surgeons involved in the randomized SYNTAX III Revolution trial. Interact Cardiovasc Thorac Surg 2019 Mar 18. pii: ivz046. doi: 10.1093/icvts/ivz046. [Epub ahead of print]