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JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP C-167

QFR Guided PCI the New Modality

By Sabapathy Diagarajan, Gurpreet Pal Singh Jugindar Singh, Mohd Ruslan Mustapa, Kengeswari Raja, Chen Tai Meng, Yew Fung Kwan, Hazleena Mohamed Hasnan, Nor Hanim Mohd Amin

Presenter

Sabapathy Diagarajan

Authors

Sabapathy Diagarajan1, Gurpreet Pal Singh Jugindar Singh1, Mohd Ruslan Mustapa2, Kengeswari Raja1, Chen Tai Meng1, Yew Fung Kwan1, Hazleena Mohamed Hasnan1, Nor Hanim Mohd Amin1

Affiliation

Hospital Raja Permaisuri Bainun, Malaysia1, Sultan Idris Shah Serdang Hospital, Malaysia2,
View Study Report
TCTAP C-167
IMAGING AND PHYSIOLOGIC LESION ASSESSMENT - Physiologic Lesion Assessment

QFR Guided PCI the New Modality

Sabapathy Diagarajan1, Gurpreet Pal Singh Jugindar Singh1, Mohd Ruslan Mustapa2, Kengeswari Raja1, Chen Tai Meng1, Yew Fung Kwan1, Hazleena Mohamed Hasnan1, Nor Hanim Mohd Amin1

Hospital Raja Permaisuri Bainun, Malaysia1, Sultan Idris Shah Serdang Hospital, Malaysia2,

Clinical Information

Patient initials or Identifier Number

CSC

Relevant Clinical History and Physical Exam

He is a 65 years old gentleman non smoker admitted to district hospital had typical chest pain diagnosed as anterior myocardial infarction received thrombolytic therapy then discharged well. However since discharge he still had chest pain on exertion CCS II. He was brought in to our hospital for an angiogram. His BP 130/74 mmHg, heart rate 67 bpm other physical examination unremarkable. 

Relevant Test Results Prior to Catheterization

ECG: sinus rhythm.
Echocardiogram: EF 44%, hypokinetic at anteroseptal region.
Blood investigations full blood count, renal profile, coagulation profile within normal limit.


Relevant Catheterization Findings

Coronary angiogram
Left main: smoothLAD: Ostial LAD CTO, collaterals from RCALCx: mid LCx 70-80%RCA: Dominant, proximal 50-60%, mid 40%


Interventional Management

Procedural Step

We proceeded with PCI to LCx QFR guided. Done via right radial approach 6F using guiding catheter EBU 3.5.
Adequate IC GTN given prior to QFR readings.QFR pre PCI 0.77.Sion blue wired into LCx.Predilated with semi compliant balloon 2.5 X 15mm @ 10 ATM, NC Scoring balloon 3.0 mm X 20mm @ 16 ATM.QFR post predilatation 0.93.Balloon angioplasty done at LCx with drug coated balloon(DCB) 3.0 X 20mm @ 7 ATM for 60 seconds.QFR post DCB 0.97.
Successful PCI to LCx with TIMI 3 flow seen. No dissection/perforation seen. No immediate complications seen.


Case Summary

Non invasive physiological ie QFR guided PCI has been new modality and widely used in current era. He is currently asymptomatic and planning for functional assessment keep in view to proceed stage PCI to CTO LAD later.