Name of the Procedure:

Noninvasive Estimated Coronary Fractional Flow Reserve (FFR) Derived from Coronary Computed Tomography Angiography (CCTA)

Summary

This procedure uses advanced computer simulations to assess blood flow in the coronary arteries by analyzing images from a CT scan. It helps determine if there are any significant blockages that could affect heart function.

Purpose

The procedure addresses suspected coronary artery disease—narrowing or blockages in the arteries supplying the heart. The goal is to evaluate the severity of these narrowings noninvasively, which helps in making decisions about further treatment or interventions.

Indications

• Chest pain or angina.
• Shortness of breath.
• Abnormal results from a stress test or other heart-related diagnostic tests.
• Known coronary artery disease needing further assessment.

Preparation

• Patients may need to fast for a few hours before the CT scan.
• Avoid caffeine and nicotine for at least 12 hours before the scan.
• Certain medications, particularly those affecting heart rate, may need to be adjusted.
• A preliminary CT scan may be performed to visualize the coronary arteries.

Procedure Description

1. The patient undergoes a coronary computed tomography angiography (CCTA) to capture detailed images of the coronary arteries.
2. The CT imaging data is then processed using specialized computational fluid dynamics (CFD) software.
3. This software simulates blood flow through the coronary arteries to estimate the fractional flow reserve (FFR), a measure of blood flow reduction due to arterial blockages.
4. No anesthesia or sedation is required since the procedure is noninvasive.

Duration

The entire process, including the CCTA scan and computational analysis, typically takes a couple of hours. However, the CT scan itself usually only takes about 15-30 minutes.

Setting

The procedure is performed in a hospital radiology or cardiology department with the necessary CT imaging facilities.

Personnel

• Radiologist or cardiologist specialized in coronary imaging.
• Radiologic technologist for operating the CT scanner.
• Software specialist or technician for conducting the CFD analysis.

Risks and Complications

• Minor exposure to radiation during the CCTA scan.
• Rarely, reactions to contrast dye used in the CT scan, such as allergic reactions or kidney function impairment.

Benefits

• Provides a noninvasive method to assess the severity of coronary artery disease.
• Helps in planning appropriate treatments, ranging from lifestyle changes to interventions like angioplasty.
• Results are typically available within a few days, allowing for timely medical decisions.

Recovery

• No specific recovery period needed as the procedure is noninvasive.
• Patients can usually resume normal activities immediately after the CT scan.
• Follow-up appointments may be scheduled to discuss results and next steps.

Alternatives

• Invasive coronary angiography: More accurate but requires catheter insertion.
• Stress tests: Can indicate functional problems with blood flow but less detailed.
• Magnetic resonance angiography (MRA): Another noninvasive imaging option but less commonly used for this purpose.

Patient Experience

• During the CCTA, patients might feel a warm sensation when the contrast dye is injected.
• A brief moment of breath-holding is required during scanning to obtain clear images.
• Post-procedure, patients may feel normal and can typically leave the facility shortly after the CT scan is completed. Pain management is usually not necessary as the procedure is painless.