Abstract
Background and Aims: Coronary artery bypass graft is the treatment of choice for left main disease. However the results from several large multicenter trials have shown that the angioplasty of left main disease is an alternative treatment. The aim of this study was to assess the outcome of patients undergoing angioplasty of left main disease.
 Methods: This prospective study was conducted at Manmohan cardiothoracic vascular and transplant center, Maharajgunj, Kathmandu, Nepal. Twenty-Five patients with a diagnosis of left main coronary artery disease who underwent coronary angioplasty were enrolled in the study. The cases were followed up and outcomes on follow up were assessed.
 Results: Patients with left main disease enrolled in this study belonged to the age group of 51 to 77 years. The mean age of patients was 64.7±8.12 with 68% (17) male and 32% (8) female. Among 25 patients 3 patients had single vessel disease, double vessel in 10 patients and triple vessel in 12 patients. Three patients (12%) had previous history of percutaneous coronary intervention and 1 (4%) had previous history of coronary artery bypass graft. All patients underwent successful procedure with unprotected left main stenting in 14 cases (56%). There was few major and minor complications and no procedure related mortality and in hospital death.
 Conclusion: Left main coronary angioplasty is a safe and alternative procedure to CABG with low incidence of major clinical events.
Highlights
Left Main (LM) coronary artery disease incidence varies between to 7%.1 It portends higher prognostic risk as a result of larger myocardial territory at risk
From 2018 January to 2019 December over two years period at Manmohan cardiothoracic Vascular and Transplant center (MCVTC), a total of 25 patients diagnosed as LM coronary artery disease who refused for Coronary artery bypass graft (CABG) were enrolled in the study
Unprotected left main stenosis was defined as a significant narrowing of the left main coronary artery without visible flow through collaterals or bypass grafts to the left anterior descending or left circumflex artery.[8]
Summary
Left Main (LM) coronary artery disease incidence varies between to 7%.1 It portends higher prognostic risk as a result of larger myocardial territory at risk. Left Main (LM) coronary artery disease incidence varies between to 7%.1. It portends higher prognostic risk as a result of larger myocardial territory at risk. Patients with unprotected left main coronary artery disease treated medically has a 3-year mortality rate of 50%.2,3. Coronary artery bypass graft (CABG) has been the therapy of choice for left main coronary artery disease for several decades.[4]. Coronary artery bypass graft is the treatment of choice for left main disease. The results from several large multicenter trials have shown that the angioplasty of left main disease is an alternative treatment. The aim of this study was to assess the outcome of patients undergoing angioplasty of left main disease
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