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Long term follow up after elective percutaneous coronary intervention for unprotected non-bifurcational left main

B R G Brueren1, J M P G Ernst, M J Suttorp

  • 1Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. brg_brueren@hotmail.com

Heart (British Cardiac Society)
|November 5, 2003
PubMed

Insights

Percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is generally not recommended. However, elective PCI of the non-bifurcational LMCA proved safe and effective in highly experienced centers.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is typically contraindicated, with coronary artery bypass graft surgery (CABG) preferred per guidelines.
  • PCI of the LMCA is reserved for exceptional circumstances.

Purpose of the Study:

  • To analyze outcomes of patients undergoing PCI of the unprotected LMCA.
  • To evaluate the safety and efficacy of elective PCI for non-bifurcational LMCA stenosis.

Main Methods:

  • Retrospective analysis of 71 patients who underwent elective PCI for non-bifurcational LMCA stenosis between 1991 and 2001.
  • Procedures included balloon angioplasty and stenting.
  • Average follow-up was 43 months.

Main Results:

  • The one-year survival rate was 98.6%.
  • Annual mortality rate was 2.5%, with most deaths due to non-cardiac causes.
  • Coronary artery bypass graft surgery was required in 18.3% of patients during follow-up.

Conclusions:

  • Elective PCI of the non-bifurcational LMCA can be performed safely at experienced centers when patient anatomy is suitable.
  • PCI offers a viable alternative to CABG in selected LMCA stenosis cases.
Abstract

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