Pre-CABG assessment of coronary stenosis with FFR-CT predicts future graft failure

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main source(s): National Institute Cardiology grant. Objectives To evaluate, whether a pre-CABG coronary computed tomography based FFR (FFR-CT) result at the site future anastomosis would predict graft failure in patients undergoing CABG. Background Functional guidance surgical revascularization remains debatable. Recently FFR-CT is recognized as suitable for diagnosis vessel-specific ischemia. Methods In 43 (mean age 65.14y (± 9.91), 15 women) who had CCTA performed less than 6 months prior to isolated CABG, follow-up were acquired >12 post CABG procedure (at median 903[IQR:468–1669] days). Based on CCTA, values simulated. On basis sites and patency determined. The was defined either its stenosis >50% or occlusion. Results 98 (44 saphenous, 54 LIMA/RIMA) grafts assessed. 18 from 16 dysfunctional CCTA. measured location significantly higher normal (0.77[0.71–0.81] vs 0.60[0.56–0.66] respectively, p = 0.0007). According multivariable Cox regression model (HR=1.1;95%CI:1.0–1.1, 0.0230), bypass RCA (HR=3.7; 95%CI:1.4–9.3 vs. LAD) independent predictors dysfunction during follow-up. optimal threshold >0.68 (sensitivity 88.9% (95%CI:65.3–98.6), specificity 63.7% (95%CI:52.2–74.2), PPV 35.6% (95%CI:28.3%-43.5%), NPV 96.2% (95%CI:87.2%-99.0%). Conclusions Pre-CABG functional predicts failure. This shows utility guiding also suggests significance physiological assessment