ABSTRACT
Long-term variations of fractional flow reserve (FFR) and instantaneous
wave-free-ratio (iFR) after transcatheter aortic valve implantation
(TAVI) have not been previously assessed. A total of 23 coronary lesions
in 14 patients with aortic stenosis (AS) underwent physiology
assessment at baseline, immediately after TAVI and at 14(7-29) months of
follow-up. The angiographic severity of the lesions did not progress at
follow-up (54[45-64] vs 54[49-63], p = .53). Overall, FFR
(0.87[0.85-0.92] vs 0.88[0.82-0.92], p = .45) and iFR (0.88[0.85-0.96]
vs 0.91[0.86-0.97], p = .30) did not change significantly compared with
the baseline. FFR decreased in 3(13%) lesions with abnormal baseline
value, whereas it remained stable in lesions with FFR > 0.80.
Conversely, iFR did not show a systematic trend at long-term after TAVI.
However, iFR demonstrated a higher reclassification rate at follow-up
compared with FFR (p = .02). In conclusions, in this exploratory study,
only minor variations of coronary physiology indices were observed at
long-term after TAVI. Nevertheless, caution should be exercised in the
interpretation of borderline FFR and iFR values in severe AS.