TRANSTHORACIC COLOR (DOPLER) ULTRASOUND OF LEFT ANTERIOR DESCENDING ARTERY AS ALTERNATIVE TO IMMEDIATE INSTANT WAVE-FREE RATIO FOR PERCUTANEOUS CORONARY INTERVENTION IN ELDERLY PATIENTS
The modern doctrine of treating ischemic heart disease (IHD) is aimed to choose a method, which maximizes the effectiveness and safety for patients. Currently there are three approaches for treatment of stable IHD: optimal medical therapy, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Each approach has own indications and contraindications, based on international recommendations. Separate controversial group of patients are the elderly and senile patients. Limited physical activity, comorbidities, high complications risk in post-PCI double antiplatelet therapy and after CABG, requires strongly individualized approach and proved treatment method. Surgery is possible only after myocardial ischemia is proved by noninvasive imaging methods, assessment of fractional flow reserve (FFR) or its alternative - instant wave-free ratio (iFR) during the coronary angiography. Determination of hemodynamically significant stenosis helps interventional cardiologists to avoid unreasonable revascularization and PCI-related complications.