Abstract
Introduction Left main coronary artery (LMCA) disease is a high-risk clinical situation, since this artery is responsible for the irrigation of more than two-thirds of the myocardial tissue, LMCA disease is associated with increased risk of adverse cardiac events. Traditionally, the gold standard of treatment for significant LMCA disase, understood as a stenosis> 50%, is coronary artery bypass grafting (CABG) surgery. – The technological evolution of percutaneous treatment and its safe application for LMCA disease in the PRECOMBAT study made [...]
Highlights
Left main coronary artery (LMCA) disease is a high‐risk clinical situation, since this artery is responsible for the irrigation of more than two-thirds of the myocardial tissue,[1] LMCA disease is associated with increased risk of adverse cardiac events.[2]
Motivated by recent studies showing divergent results on the comparison between surgical and percutaneous approach for LMCA disease, in this article we briefly review the results of the two forms of treatment, focusing on the recent evidences and controversies, but mainly on the lessons learned from these studies and their applicability in clinic care
The question is whether medium and long-term results are equivalent to the surgical results, which have been supported by clinical studies and registries through decades of follow-up
Summary
Left main coronary artery (LMCA) disease is a high‐risk clinical situation, since this artery is responsible for the irrigation of more than two-thirds of the myocardial tissue,[1] LMCA disease is associated with increased risk of adverse cardiac events.[2]. The technological evolution of percutaneous treatment and its safe application for LMCA disease in the PRECOMBAT study made it a viable alternative, initially restricted to patients at high surgical risk and with LMCA disease confined to the proximal portion of the trunk.[8] Subsequent studies have suggested the equivalence of percutaneous coronary intervention (PCI) and CABG in low and moderate complexity LMCA disease,[9] which was reflected in the most recent guidelines (Table 1). Motivated by recent studies showing divergent results on the comparison between surgical and percutaneous approach for LMCA disease, in this article we briefly review the results of the two forms of treatment, focusing on the recent evidences and controversies, but mainly on the lessons learned from these studies and their applicability in clinic care
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