A practical and effective protocol for the post angiographic management of patients with critical stenosis of the left main coronary artery.
The management of newly diagnosed left main obstruction varies throughout institutions. At some Centers, very aggressive measures including intra-aortic balloon counterpulsation and emergent revascularization are routine protocol. Twenty consecutive patients with greater than 50% luminal narrowing of the left main coronary artery were treated over a 1 year period. Routine post catheterization protocol for 19 patients included intensive care observation, continuation of nonparenteral anti-anginal agents, and coronary revascularization within 24 hours of diagnosis. One patient experienced severe hemodynamic embarrassment at the time of catheterization and underwent emergency coronary bypass. All patients were discharged uneventfully following successful surgery. Based on this experience, it is felt that with surgical support, patients with significant left main stenosis can be treated with standard anti-anginal therapy, and undergo elective revascularization without complications.
D000328:Adult; D000368:Aged; D000792:Angiography; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D013997:Time Factors