title: Left main intervention revisited: early and late outcome of PTCA and stenting.
abstract: We reviewed our experience with 28 unselected, consecutive patients undergoing left main coronary artery (LMCA) angioplasty who had been considered unsuitable for coronary artery bypass graft surgery (CABG). Fourteen patients (50%) had a protected LMCA circulation. Balloon angioplasty was performed in 11 patients (39.3%), and stents were implanted in 17 patients (60.7%). The procedure was elective in 22 patients (78.6%) and acute in the setting of myocardial infarction/cardiogenic shock in 6 (21.4%). The mean follow-up duration was 15.9 +/- 12 months. There were 5 early (before hospital discharge) and 4 late deaths (total 32.1%), 1 myocardial infarction (3.6%), 6 repeat angioplasties (21.4%), and 3 subsequent CABG (10.7%). All 5 early deaths occurred in patients with cardiogenic shock and unprotected circulation. The results of our study suggest that when patients have prohibitive surgical risks, elective LMCA angioplasty and/or stenting may be undertaken with a high procedural success rate. However, our data do not support intervention in the presence of acute myocardial infarction/cardiogenic shock.
authors.forename: A
authors.initials: A
authors.lastname: Chauhan
authors.forename: M
authors.initials: M
authors.lastname: Zubaid
authors.forename: D R
authors.initials: DR
authors.lastname: Ricci
authors.forename: C E
authors.initials: CE
authors.lastname: Buller
authors.forename: M D
authors.initials: MD
authors.lastname: Moscovich
authors.forename: B
authors.initials: B
authors.lastname: Mercier
authors.forename: R
authors.initials: R
authors.lastname: Fox
authors.forename: I M
authors.initials: IM
authors.lastname: Penn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome