Left Main Stenosis – Where Do We Stand?

Abstract

The presence of significant left main coronary disease is associated with increased mortality. Limited data examining the role of surgery in patients with a left main stenosis suggest a significant improvement in longevity. With the advent of coronary stenting, particularly the use of drug-eluting stents and improvements in percutaneous technology, left main coronary intervention has become more commonplace. However, despite important advances in the understanding of left main disease, management can be challenging. Many aspects, including the assessment of significance and the need for and choice of intervention (surgical or percutaneous revascularisation), remain unclear. This article serves to facilitate the management of patients with left main coronary disease with a focus on the assessment of lesion significance and the role of percutaneous intervention.