Management of left main disease: an update

被引：34

作者：

Fajadet, Jean ^{[1
]}

Capodanno, Davide ^{[2
,3
]}

Stone, Gregg W. ^{[4
]}

机构：

[1] Clin Pasteur, Toulouse, France

[2] Univ Catania, Azienda Osped Univ Policlin Vitto Emanuele, CAST, Div Cardiol, Catania, Italy

[3] Univ Catania, Dept Gen Surg & Med Surg Specialties, Catania, Italy

[4] Columbia Univ, New York Presbyterian Hosp, Med Ctr, Cardiovasc Res Fdn, New York, NY USA

来源：

EUROPEAN HEART JOURNAL | 2019年 / 40卷 / 18期

关键词：

Left main; Left main coronary artery; Percutaneous coronary intervention; Coronary artery bypass grafting; PERCUTANEOUS CORONARY INTERVENTION; EVEROLIMUS-ELUTING STENTS; FRACTIONAL FLOW RESERVE; BYPASS GRAFT-SURGERY; INTRAVASCULAR ULTRASOUND GUIDANCE; DOUBLE KISSING CRUSH; LONG-TERM MORTALITY; SYNTAX SCORE-II; ARTERY-DISEASE; BIFURCATION LESIONS;

D O I：

10.1093/eurheartj/ehy238

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A severe narrowing of the left main coronary artery (LMCA), usually due to atherosclerosis, jeopardizes a large area of myocardium and increases the risk of major adverse cardiac events. Management strategies for LMCA disease include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). In general, PCI offers more rapid recovery and a lower early adverse event rate, whereas CABG offers a more durable procedure. The largest of six LMCA trials comparing PCI with CABG recently reported that in patients with site-reported low or intermediate anatomical complexity PCI was non-inferior to CABG with respect to the composite of death, stroke, or myocardial infarction at 3 years. This result was obtained on a background of contemporary PCI standards, including safer and more effective stents, intravascular imaging and physiology assessment. This review updates on the current management of LMCA disease, with an emphasis on clinical data and procedural knowledge supporting the use of PCI in a growing proportion of patients.

引用

页码：1454 / +

页数：15

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