PhD defence K. (Ken) Masdjedi

Fractional Flow Reserve (FFR) guided percutaneous coronary intervention (PCI) has been shown to impr ove both patient outcome and cost-effectiveness as compared to angiography guided PCI. (1-4) In the past years, FFR has become the gold standard for hemodynamic assessment of intermediate coronary artery lesions resulting in a class IA recommendation in current revascularization guidelines. (5, 6) At the same time, the use of post PCI physiological assessment is gaining attention. A strong and linear association has been demonstrated between post PCI FFR and the risk for both future repeat revascularization as well as hard clinical endpoints as death and myocardial infarction. (7-9) However, despite unequivocal evidence supporting the use of FFR to guide clinical decision-making, adoption into routine practice has been limited and in particular FFR assessment after stenting is rarely performed. The latter illustrates the need for tools that allow simple and fast post PCI physiological assessment without the need for a pressure wire and hyperemic agent. The aim of the present thesis was: 1) to evaluate the distribution of post-PCI FFR and to investigate its clinical impact on long terms clinical outcomes. 2) to validate a novel non-hyperemic diastolic pressure ratio and to evaluate its post PCI value in terms of clinical outcome and 3) to develop and to validate a 3D angiography based index allowing fast and easy physiological lesion assessment without the need for an invasive pressure wire in order to further lower the threshold for performing coronary physiology in routine practice.

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 10.30 AM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.