FFR

Fractional Flow Reserve

Fractional flow reserve (FFR) is a technique used in coronary catheterization to measure pressure differences across a coronary artery  stenosis to determine if stenosis impedes oxygen delivery to the heart muscle.

Indications:

  • Multivessel disease
  •  Acute coronary syndrome
  • Left main lesions
  • Bifurcations
  • Bypass grafts

During coronary catherization

  1. A catheter is inserted into the femoral or radial arteries
  2. A sheath and guidewire
  3. FFR uses a small sensor on the tip of the wire
  4. To measure pressure, temperature and flow
  5. Which determines the exact severity of the lesion
  6. Done during maximal blood flow
  7. Induced by products such as adenosine or papaverine
  8. Wire is pulled back
  9. Pressures recorded across the vessel

Equation

FFR is the ratio of maximum blood flow distal to a stenotic lesion to normal maximum flow in the same vessel. It is calculated using the pressure ratio. Where,

Pd = Pressure distal to the lesion
Pa = Pressure proximal to the lesion

Equipment

  • Guiding catheter
  • Pressure monitoring guidewire
  • Hyperemic stimulus
  • Vasodilation administration – to achieve maximal hyperemia of coronary artery

Complications: Rare

  • Transient bradycardia (1.7%)
  • Coronary spasm (2%)
  • Ventricular fibrillation (0.2%)
  • Vessel trauma

  • "Dr. Sharath Reddy is the best cardiologist in Hyderabad. We underwent the heart treatment under him. We are very happy with the treatment."

    SREE VATSAVA - HEART PATIENT

  • I would like to thank Dr Sharath Reddy and his team for the excellent cardiac care and treatment provided to me. I have been given all the information and advice to lead my life in a comfortable way after the procedure. I can’t thank you enough for all your time, hard work, and patience. I truly appreciate your caring dedication.

    Narayana E

  • My brother had severe dyspnoea (shortness of breath) and it was difficult for him to walk for even very small distances. He had severe pedal oedema (feet swelling) and was not able to do routine activities on his own. But after TAVI procedure he is able to breathe well and walk comfortably for small distances without any difficulty. Within a short time after the TAVI procedure he is performing his routine own activities. We are grateful to the cardiac team at Medicover Hospitals.

    Hanumantha Rao