Intervention in Left Main Coronary Artery Disease in High Surgical Risk Patients: Current Approaches and Outcomes

Left Main Coronary Artery Disease (LMCAD) is a critical condition that poses significant risks due to its potential to compromise a large myocardial territory. Patients with LMCAD who are deemed high surgical risks present a unique challenge, as the standard surgical approach, coronary artery bypass grafting (CABG), may be contraindicated or associated with high morbidity and mortality. This article reviews contemporary interventional strategies for managing LMCAD in high-risk surgical patients, with a focus on percutaneous coronary intervention (PCI) and the use of drug-eluting stents (DES). We evaluate clinical outcomes, procedural success rates, and long-term prognosis, comparing these with traditional surgical approaches. Additionally, we discuss patient selection criteria, risk stratification, and the role of multidisciplinary heart teams in optimizing treatment strategies. By synthesizing the latest evidence and clinical guidelines, we aim to provide a comprehensive overview of the interventional management of LMCAD in this vulnerable patient population.