MY HEART IS BEATING.........ANGIOGRAPHY or FFR

                      MY HEART IS BEATING..........ANGIOGRAPHY or FFR

A recent TOI news item about a new technology to reduce Coronary Bypass and Stenting seized my attention.  The general medical advice for treating blocked arteries is Angiography followed by Stenting or By-pass surgery. However, the article reports a new diagnostic procedure called Fractional Flow Reserve (FFR) which can cut down the need for Stenting or By-pass surgery.

 What the Doctors do is to introduce a guide-wire into the artery in order to reach the spot where the blockage is. The wire has a device attached to it for measuring the pressure levels  on both the sides of the block. The results are fed to a monitor.  Thereafter, the ratio between the maximum achievable blood flow in the diseased coronary artery and the theoretical maximum flow in a normal coronary artery is worked out. FFR lower than 0.80 is considered to be associated with Myocardial Ischemia. In simple words if the ratio is between 0.8 to 1.0 the block does not need an invasive procedure and can be managed with medicines; on the other hand, lower than 0.8 score means procedures like Stenting or By-pass are necessary.

   Why FFR has not picked up so far as a diagnostic procedure is associated with its cost. While an Angiogram costs around Rs 15,000/-, FFR results in almost doubling the expense to nearly Rs  30,000/-. According to TOI, a recent study has revealed that using FFR has reduced the need for Stenting by 42% and By-pass by 50%. Hence, additional expenditure on FFR may just result in doing away with the enormous expense, post-op care & the risk involved in Stenting or By-pass. Thus, weighing the pros and cons, it would seem advisable to opt for this new technology.

 For more information, please refer to the link http://gsheart.com/images/news-tech.jpg  provided in the website http://gsheart.com/ of Dr G Sengottuvellu, Interventional Cardiologist and Senior Consultant Cardiologist of Apollo Hospitals, Chennai.