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Multivessel Disease

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Textbook of Cardiovascular Intervention

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Abstract

The decision to treat Multivessel disease (MVD) with Percutaneous Coronary Intervention (PCI) requires careful consideration and an orderly approach. An initial thorough assessment of MVD starts with defining the coronary anatomy and the extent of disease, for example, the number and characteristics of lesions involved including attention to calcification, tortuosity, and bifurcation involvement. An assessment of left ventricular ejection fraction is essential to understanding the overall clinical picture. Other comorbid clinical conditions including chronic kidney disease, diabetes mellitus, presence of a bleeding diathesis, and intolerance to or nonadherence to medications can be confounding factors in determining the mode of revascularization. In addition to the gross angiographic assessment of the number and degree of stenosis, objective evaluation of disease extent and its prognostic significance should be assessed. Various scoring systems, including, for example, the SYNTAX score, Global Risk Score (GRC), New Risk Stratification (NERS), EuroSCORE, and STS, can help us better evaluate the relative risks of revascularization strategies and help determine the most appropriate revascularization approach.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, 161 Fort Washington Avenue, 6th Floor, New York, NY, 10032, USA

    Vishal Kapur MD, Ajay J. Kirtane MD, SM & Jeffrey W. Moses MD

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  1. Vishal Kapur MD
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  2. Ajay J. Kirtane MD, SM
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  3. Jeffrey W. Moses MD
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Correspondence to Jeffrey W. Moses MD .

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Editors and Affiliations

  1. Department of Medicine, Cardiology Section, Director, Cardiovascular Catheterization and Intervention, Yale New Haven Hospital, Director, Invasive Cardiology and Vascular Medicine,, New Haven, Connecticut, USA

    Craig A. Thompson

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© 2014 Springer-Verlag London

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Kapur, V., Kirtane, A.J., Moses, J.W. (2014). Multivessel Disease. In: Thompson, C. (eds) Textbook of Cardiovascular Intervention. Springer, London. https://doi.org/10.1007/978-1-4471-4528-8_21

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  • DOI: https://doi.org/10.1007/978-1-4471-4528-8_21

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