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Left Main Coronary Artery Intervention

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Abstract

The left main coronary artery (LMCA) supplies the majority of blood to the left ventricle. This fact alone explains why untreated obstructive LMCA disease is associated with a poor prognosis. Coronary artery bypass grafting (CABG) has a clear indication with a proven mortality benefit and it has been conventionally regarded as the gold standard treatment for LMCA disease. However, thanks to evolving technologies and technique, trials have progressively supported the alternative use of coronary stents in certain patient subsets with LMCA disease. In left main disease particularly, stringent technique is essential to obtain an optimal and durable result. Rigorous procedural planning, application of appropriate procedural imaging and lesion preparation together with careful patient-selection, are crucial in LMCA intervention. The aim of this chapter is to guide the reader through the main aspects that need attention when dealing with LMCA disease and provides a practical algorithm to apply in the catheterization laboratory.

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Authors and Affiliations

  1. Oxford Heart Centre, John Radcliffe Hospital, Oxford University Hospital NHS Trust, Oxford, UK

    Giovanni Luigi De Maria & Adrian Paul Banning

Authors
  1. Giovanni Luigi De Maria
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  2. Adrian Paul Banning
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Correspondence to Adrian Paul Banning .

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Editors and Affiliations

  1. Brighton and Sussex Medical School and the Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK

    Aung Myat

  2. Royal Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK

    Sarah Clarke

  3. Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Nick Curzen

  4. Department of Cardiology, Bern University Hospital, Bern, Switzerland

    Stephan Windecker

  5. Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, VA, USA

    Paul A. Gurbel

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De Maria, G.L., Banning, A.P. (2018). Left Main Coronary Artery Intervention. In: Myat, A., Clarke, S., Curzen, N., Windecker, S., Gurbel, P.A. (eds) The Interventional Cardiology Training Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-71635-0_27

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  • DOI: https://doi.org/10.1007/978-3-319-71635-0_27

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