Flawless presentation. Please do more lectures as your sessions are super clear and helpful and they will help students like me to understand the key concepts.
Thanks for watching. On the FFR waveform, try to pay attention to the diastolic drift (Drop in the diastolic pressures) and separation of the two waveforms which is very specific. When you say “maximum hyperemia” it is by definition two minutes into the test but you can see it as early as in the first 40-50 seconds. I hope this help..
@@whiteboardandmarkercardiol2787 Thank you for your response. So it would be the lower systolic pressure = max hyperemia, after the adenosine was given?
@@AG-lk4lq not really. Its just a visual check to make sure everything is in proper place. The actual “maximum hyperemia” by definition will be spitted out by the computer as a final FFR ratio once you stop the recording. So, it is important that you keep the adenosine going for complete two minutes even if it is grossly positive in the first minute or so. Unless the patient start having severe symptoms or side effects..
Great question. You have to look and find the healthy segment and compare with lesion. Thats the reason why its always foiled with errors and we end up doing FFR.
Siluleko. Yes, you are right. The trials targeted 0.75 but the meta-analysis showed 0.80 or less is acceptable to intervene to decrease mortality and morbidity. Now the consensus it to treat 0.80 or less. Hope this helps
Hi. Not entirely sure about the question if I understood it correctly. During PCI we do use wires and the number and type of wires will differ with the complexity of the lesion. Happy to answer if you elaborate.. thanks
@@millennialgamer239 . Here you go.... Putting two wires one in the side branch can serve three purpose (As per LOTUS trial) 1. Serve as a marker to recanulate the side branch if it gets pinched and no reflow. 2. Helps preventing the plaques shift into the side branch. 3. Gives body and stiffness to the side branch in case there is plaque shift leading to angulation and closure of the side vessel. I hope this help..
Extremely helpful and detailed presentation!
Thank you for posting this exceptionally helpful video
Beautifully presented ❤❤❤❤
crystal clear explanation on FFR. Thanks a lot sir.
Great Job. Quick and helpful
Thanks a lot. Glad this was helpful,,
Flawless presentation. Please do more lectures as your sessions are super clear and helpful and they will help students like me to understand the key concepts.
Thanks a lot for such a nice comment and watching the videos. Will do..
@@whiteboardandmarkercardiol2787 You are most welcome, Doctor. Could you do some lectures on OCT & IVUS ?
@@gautamnair1785 will note it down. Thnx
Really enjoy you videos...excellent explanation always..thank you.
Thanks for watching and thanks for the nice comment…
great job!!!! easily understood!
Thnx for watching and the nice comment
Fantastic explanation
Thank you , you made it realy simple to understand
Sultan. You are welcome and thanks for watching.
Thank you for this. If I am looking at the FFR Waveform, where would you say I would be able to see "maximum hyperemia"?. Thanks!
Thanks for watching. On the FFR waveform, try to pay attention to the diastolic drift (Drop in the diastolic pressures) and separation of the two waveforms which is very specific. When you say “maximum hyperemia” it is by definition two minutes into the test but you can see it as early as in the first 40-50 seconds. I hope this help..
@@whiteboardandmarkercardiol2787 Thank you for your response. So it would be the lower systolic pressure = max hyperemia, after the adenosine was given?
@@AG-lk4lq not really. Its just a visual check to make sure everything is in proper place. The actual “maximum hyperemia” by definition will be spitted out by the computer as a final FFR ratio once you stop the recording. So, it is important that you keep the adenosine going for complete two minutes even if it is grossly positive in the first minute or so. Unless the patient start having severe symptoms or side effects..
@@whiteboardandmarkercardiol2787 Thank you very much! This is all very helpful!
Very instructive. Is IFR done by some special software or it requires specific hardware?
Thank you sir
Very informative and easily understandable presentation
Thank you very much sir
You are welcome and thanks for watching. Appreciated
Thank you doc very well explained..highly appreciated..
You are welcome and thanks for watching. Appreciated
Very good lecture👏
Thank you so much for this video! I do have a small question, do you obtain FFR 1min into administering adenosine?
Thank you 👌👌👌
Thanks a lot sir ❤
Very nice conceftual
Sir ,ur lecture is very useful and basic ,pls I want to learn more ,I'm a Nursing officer in cathlab since one yr .
Thanks Neeta. Glad they are helpful and good luck with your job and all the amazing things you do as a healthcare provider for the patients....
How is the % quantified via angiography? How can one just “eyeball” and guesstimate the blockage %?
Great question. You have to look and find the healthy segment and compare with lesion. Thats the reason why its always foiled with errors and we end up doing FFR.
Thanks
Hello Sir,
Thank u very informative and easy to understand video
Can i request videos on OCT and IVUS as well if possible plz?
Keny. Will cover it soon. Thanks for the suggestion. I think it will be a good topic to review.
Tq you so much sir
Sir..is this coronary flow reserve and fractional flow reserve are same?
Thanks sir
Thank you sir
Thanks Aashish. Thanks for watching…
Aren't stenoses 0.75-0.80 called the "gray zone"?
Siluleko. Yes, you are right. The trials targeted 0.75 but the meta-analysis showed 0.80 or less is acceptable to intervene to decrease mortality and morbidity. Now the consensus it to treat 0.80 or less. Hope this helps
sir plz make a video on ifr seperately.
it was a really nice lecture.
Thanks for watching. Will note it down..
Hello sir. What is the rationale why they are using 2 wires or 3 wires during PCI?
Hi. Not entirely sure about the question if I understood it correctly. During PCI we do use wires and the number and type of wires will differ with the complexity of the lesion. Happy to answer if you elaborate.. thanks
@@whiteboardandmarkercardiol2787 Like when they try to do the bifurcation. I just wanted to know what is thet purpose of putting 2 wires?
@@millennialgamer239 . Here you go.... Putting two wires one in the side branch can serve three purpose (As per LOTUS trial)
1. Serve as a marker to recanulate the side branch if it gets pinched and no reflow.
2. Helps preventing the plaques shift into the side branch.
3. Gives body and stiffness to the side branch in case there is plaque shift leading to angulation and closure of the side vessel.
I hope this help..
@@whiteboardandmarkercardiol2787 I see. Thank you sir. Hope you continue your lectures. I like it im a csth nurse and I learn from ur lectures.
Hello sir could you cover basics of cardiac angiography
Hi Shally. I have a video on basics of angiographic views
czcams.com/video/HZEqRrQzZao/video.html
What in particular you want me to cover?
Thanks
Amo
Sir …. Put a discussion on CT FFR Also
Thank u
Will do. Thanks for watching.
@@whiteboardandmarkercardiol2787 In addition to CT FFR, could you also discuss some of the current limitations of FFR?. Thanks