Physiologic assessment using fractional flow reserve (FFR) provides a more accurate assessment of the hemodynamic significance of coronary artery stenosis than coronary angiography alone. FFR-guided percutaneous coronary intervention (PCI) achieves better short- and long-term outcomes compared to PCI guided by angiography or drug therapy. Angiography-derived FFR estimates FFR from standard coronary angiography images using computational fluid dynamics or related algorithms. This method does not require pressure wire feeding or good correlation reagents. The article focuses on physiologically guided CABG in heart valve surgery.