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Textbook of Catheter-Based Cardiovascular Interventions pp 723–744Cite as

Interventional Therapy of Left Main Coronary Artery Disease

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Abstract

Current evidence from real-world registry data and clinical trials suggests that percutaneous coronary intervention (PCI) with a drug-eluting stent can achieve similar rates of safety outcomes such as death, myocardial infarction, or stroke as compared with standard coronary artery bypass graft surgery (CABG) for patients with unprotected left main coronary artery (LMCA) disease. The inferior efficacy outcome with stenting has been continuously improved through developments in stent technology. As a result, PCI has become an acceptable alternative to CABG in selected patients considered suitable for either strategy of revascularization. The standard approach for patients presenting with significant LMCA disease is evaluation by a heart team that includes both interventional cardiologists and cardiac surgeons. The team decides by consensus whether to opt for PCI or surgery on the basis of the hemodynamic status of the patient, lesion characteristics, vessel size, the presence of comorbidities, quality of arterial and/or venous conduits for grafting, and the preferences of the patient and/or referring physician.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea

    Pil Hyung Lee, Duk-Woo Park & Seung-Jung Park

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  1. Pil Hyung Lee
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  1. Middle German Heart Center and Health Care Center Bitterfeld-Wolfen, gGmbH, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Lee, P.H., Park, DW., Park, SJ. (2018). Interventional Therapy of Left Main Coronary Artery Disease. In: Lanzer, P. (eds) Textbook of Catheter-Based Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-55994-0_45

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