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Tests & procedures

Fractional Flow Reserve

NB: If you suffer from Asthma or other airway disease please inform your Doctor

What is a Fractional Flow Reserve (FFR)?

Fractional Flow Reserve, or FFR, is a procedure that can accurately measure flow through a coronary artery. FFR is done through a special guide wire. The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting (PCI )on a coronary narrowing.

How do they do an FFR?

A very thin guide wire is inserted during an angiogram (refer to Angiogram Fact Sheet). The special guide wire crosses the lesion. The doctor will administer a medication (adenosine) to relax your artery, increasing the flow of blood through it. This enables them to take measurements of the flow and pressure within the artery at the site of the narrowed area. Results are displayed on a special monitor along with the “FFR value”. From this measured value, the Cardiologist can determine whether or not you need to have a stent inserted. The medication that they give to you may give you a strange sensation of chest tightness, shortness of breath or even a feeling of ‘impending doom’. Be reassured that the nurses will talk you through this and remember; it is being done in a controlled environment.

Before the FFR:

To prevent infection, you will be shaved and cleaned around the area of your groin or arm where the catheter tube will be inserted.

A needle with a line connected to it will be put into a vein in your arm or hand. This is called an intravenous line or IV. It is used to give you fluid and any other medications that you may require during the procedure.       

During the FFR:

You will be awake during the procedure and given a local anaesthetic to numb the area where the catheter tube will be inserted. You may feel some mild discomfort. The Doctor will insert a hollow tube (sheath) into your artery through a small puncture site. Then they will insert the catheter tube through the sheath. The catheter is gently threaded through the main artery and into your coronary arteries. The special guide wire crosses the lesion and is able to measure the flow of blood.

This procedure helps to determine the severity of a narrowing and identifies to your cardiologist an area that may require a stent; you may proceed directly to this procedure. (Angioplasty- refer to booklet)

How long will it take?

An FFR may take approximately 30 minutes and then a stent insertion could take another 30-45 minutes ,depending of the complexity of the procedure . You will need to be able to lie flat for this procedure.

After the FFR:

After the procedure you will be moved to the Coronary Care Unit for an overnight stay. You will need to remain in bed for a few hours (4-6 hours) after the procedure. The sheath that was inserted into your artery will be removed by the nursing staff and they will apply firm pressure for 20 mins to seal the puncture site. Regular checks will be done and the nurses will keep you informed as to your progress and when it is safe for you to mobilise.

Going Home:

If you live more than an hour away from the hospital you are required to stay locally for another 24hours after discharge from hospital.

Returning to work:

You can usually be back at work within a week (depending on the type of work that you do).This will be clarified by the medical team before you are discharged.