Significant Left Main Artery Stenosis Research Articles

Percutaneous Revascularization for Left Main Coronary Artery Compression From Pulmonary Artery Enlargement Due to Pulmonary Hypertension

Extrinsic compression due to pulmonary artery enlargement from severe pulmonary hypertension is an uncommon cause of hemodynamically significant left main artery stenosis. Patients with severe pulmonary hypertension who experience angina should be evaluated for possible extrinsic compression of the left main artery due to pulmonary artery enlargement. Although computed tomographic angiography and cardiac magnetic resonance imaging are helpful in the screening for extrinsic left main artery compression, coronary angiography is the gold standard for the diagnosis. Percutaneous coronary intervention of the left main artery is feasible, safe, and a reasonable initial revascularization strategy for these patients because of the high risk of postoperative right ventricular failure and mortality observed with bypass surgery.

Off-Pump Coronary Artery Bypass Graft (OPCABG) Surgery in Patients with Left Main Coronary Artery Stenosis: Analysis of Experience in 145 Patients

The presence of significant left main arterial stenosis has been considered a relative contraindication to OPCAB surgery. The development of newer techniques and an increasing understanding of the hemodynamic changes make the surgeons confident to perform OPCAB in patients with significant left main artery stenosis. Between January 2004 to March 2008, 145 patients with left main artery stenosis underwent OPCAB surgery at NICVD. Gradual adoption and integration of maturing heart surgery in fast years led to a trend towards overall improvement in CABG outcomes. Off-pump coronary artery surgery appears to be a safe and effective technique in patients with significant Left Main coronary artery disease. The postoperative morbidity and length of ICU and hospital stay are shorter. OPCAB could be an effective alternative to the conventional method CABG with same or better early results and is cheap and cost effective. The long-term results are to be evaluated DOI: 10.3329/bmj.v37i2.3592 Bangladesh Medical Journal 37(2) 2008 46-49