Related Experiment Video
Updated: Sep 29, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Short- and Long-Term Outcomes of Left Main Coronary Artery Stenting in Patients Disqualified from Coronary Artery
Wojciech Jan Skorupski1, Marta Kałużna-Oleksy1, Maciej Lesiak1
11st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland.
Insights
Left main percutaneous coronary interventions (LM PCI) offer a safe and effective treatment for patients ineligible for coronary artery bypass graft surgery (CABG). While LM PCI shows low in-hospital complications, long-term mortality is higher in this complex patient group.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
- Clinical Outcomes Research
Background:
- Left main coronary artery disease (LMCD) poses significant risks.
- Coronary artery bypass graft surgery (CABG) is the traditional revascularization strategy.
- Percutaneous coronary intervention (PCI) is an alternative for select patients.
Purpose of the Study:
- To evaluate short- and long-term outcomes of LM PCI.
- To compare outcomes in patients disqualified from CABG versus those offered PCI as an alternative.
- To assess the safety and efficacy of LM PCI in high-risk patients.
Main Methods:
- Retrospective analysis of 459 patients undergoing LM PCI.
- Comparison between patients offered PCI as CABG alternative (Group 1) and those disqualified from CABG (Group 2).
- Assessment of procedural success, complications, and long-term mortality.
Main Results:
- Group 2 patients had higher SYNTAX and Euroscore II, and lower ejection fraction.
- Complex stenting techniques were more frequent in Group 2.
- Procedure success rates were high and similar; no difference in periprocedural complications.
- Long-term all-cause mortality was higher in Group 2 (26% vs. 21%).
Conclusions:
- LM PCI is an effective and safe option for patients disqualified from CABG.
- The procedure demonstrates a low in-hospital complication rate.
- While short-term outcomes are favorable, long-term mortality warrants consideration in this high-risk population.
Abstract:
The study aims to evaluate the short- and long-term outcomes of left main percutaneous coronary interventions (LM PCI) in patients disqualified from coronary artery bypass graft surgery (CABG). We included 459 patients (mean age: 68.4 ± 9.4 years, 24.4% females), with at least 1-year follow-up; 396 patients in whom PCI was offered as an alternative to CABG (Group 1); and 63 patients who were disqualified from CABG by the Heart Team (Group 2). The SYNTAX score (29.1 ± 9.5 vs. 23.2 ± 9.7; p < 0.001) and Euroscore II value (2.72 ± 2.01 vs. 2.15 ± 2.16; p = 0.007) were significantly higher and ejection fraction was significantly lower (46% vs. 51.4%; p < 0.001) in Group 2. Patients in Group 2 more often required complex stenting techniques (33.3% vs. 16.2%; p = 0.001). The procedure success rates were very high and did not differ between groups (100% vs. 99.2%; p = 0.882). We observed no difference in periprocedural complication rates (12.7% vs. 7.8%; p = 0.198), but the long-term all-cause mortality rate was higher in Group 2 (26% vs. 21%; p = 0.031). LM PCI in patients disqualified from CABG is an effective and safe procedure with a low in-hospital complication rate. Long-term results are satisfactory.
More Related Videos
09:12Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
13:10Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
Published on: April 24, 2017
Related Concept Videos
01:22Mitral Stenosis I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:24Cardiac Catheterization III: Left Heart Catheterization