Quantitative Flow Ratio (QFR) Directed Revascularization Approach for Patients Receiving Primary Valve Surgery Having Coronary Artery Disease

Background: Diagnostic Coronary Angiography (DCA) is the gold standard for detecting coronary artery disease (CAD). Percutaneous Coronary Intervention (PCI) is being done more often in patient with multivessel coronary artery disease (CAD).  This study describes the effectiveness of a QFR-directed revascularization procedure and a coronary angiography (CAG)-directed revascularization procedure in patients with scheduled primary valvular surgery having coronary artery lesions with diameter stenosis of 50%. Within 30 days of surgery, the combined outcome of (all-cause of death, non-fatal myocardial infarction, non-fatal stroke, unplanned coronary revascularization, new renal dysfunction involving dialysis).

Methods: The study is conducted through QFR procedure along with heart disease like Aortic stenosis (AS), in patients receiving primary valve surgery, like Aortic valve replacements having coronary artery disease. So, the results of this method are to compare the usefulness and cost-effectiveness of a QFR-guided PCI strategy versus an angiography-guided PCI strategy in patients undergoing primary valve surgery having coronary artery disease.

Result: It shows that QFR strategy is the new advanced method, where patients can save time and money at the same time and less invasive the effectiveness of a QFR-guided PCI strategy against an angiography-guided PCI strategy is that QFR-guided approach have better clinical results and more cost-effective than a conventional angiography-guided strategy, as shown by a lower prevalence of MACE (major adverse cardiac event) at one year.  on the other side, coronary artery disease is often linked to valvular heart disease (VHD). In valve cardiac surgery patients, the CAD was detected in 27.75% of all severe VHD patients, for 32% of aortic valve disease isolated and for 15% of mitral valve of isolated patients. In patients with severe aortic stenosis there was a significant relationship between CAD and aortic valve disease. Larger studies are required in the future to determine the potential causal relationship. 

Conclusion: We come to know that QFR guided strategy is very effective the QFR-guided approach has better clinical results and be more cost-effective than a conventional angiography-guided strategy, as shown by a lower prevalence of MACE (major adverse cardiac event) at one year. On the other side, the TAVR and PCI will be the main driver in aortic stenosis and coronary artery disease (CAD) is significantly correlated with AS. remember that coronary artery disease (CAD) associated with valvular heart disease (VHD). SAS is the most common valve problem that necessitates surgical or percutaneous treatment. CAD, on the other hand, is one of the leading causes of death in developed countries. There are several risk factors for CAD and degenerative SAS, and they are usually identified jointly in clinical practice. Even though transcatheter aortic valve replacement (TAVR) has drastically changed the therapeutic approach to SAS in recent years, the right treatment of patients with concomitant CAD remains a point of contention due to a shortage of data in the literature.