Left Main Stem Stenosis: How to Proceed

Chapter

Abstract

Coronary artery bypass surgery is considered as the gold standard for the treatment of unprotected left main stem disease. Over recent years, advancements in interventional cardiology, data from clinical studies and operators’ experience has led to an increase in the number of patients undergoing percutaneous coronary intervention for the treatment of left main stem disease. However, special care is needed because the left main stem transmits 70–100 % of the blood supply to the left ventricle, and a complication involving the left main stem is likely to have high morbidity and mortality. In this chapter we will discuss the potential complications of PCI to the left main stem intervention and how to prevent and manage them.

Keywords

Left main stem Angioplasty Complications 

References

  1. 1.
    Fajadet J, Chieffo A. Current management of left main coronary artery disease. Eur Heart J. 2012;33:36–50b.CrossRefPubMedGoogle Scholar
  2. 2.
    Iqbal J, Serruys PW, Taggart DP. Optimal revascularization for complex coronary artery disease. Nat Rev Cardiol. 2013;10:635–47.CrossRefPubMedGoogle Scholar
  3. 3.
    Mohr FW, Morice MC, Kappetein AP, Feldman TE, Stahle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381:629–38.CrossRefPubMedGoogle Scholar
  4. 4.
    Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35:2541–619.CrossRefPubMedGoogle Scholar
  5. 5.
    Park SJ, Kim YH, Park DW, Lee SW, Kim WJ, Suh J, et al. Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis. Circ Cardiovasc Interv. 2009;2:167–77.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Department of CardiologySheffield Teaching Hospitals NHS Foundation TrustSheffieldUK

Personalised recommendations