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Interventional Therapy of Left Main Coronary Artery Disease

  • Pil Hyung Lee
  • Duk-Woo Park
  • Seung-Jung Park
Chapter

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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Cardiology, Department of MedicineUniversity of Ulsan College of MedicineSeoulSouth Korea

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