Key result
Optimal treatment of left main disease requires considering the revascularization method, patient condition, peri-operative risk, and pharmacotherapy, making a heart team crucial.
A heart team approach is crucial for determining the optimal revascularization strategy in patients with left main disease, particularly in complex subgroups.
Surgical revascularization with coronary artery by-pass grafting is still recommended in vast majority of patients with unprotected left main disease. The aim of the paper was to analyze optimal treatment of left main disease in selected groups of patients, on the basis of current guidelines and information gained from literature data. We focused on data in relation to treatment of elderly patients, diabetics and those hemodynamically unstable. Additionally we discussed the issue of anti-platelet therapy and informed consent. As far as efficacy of treatment is concerned, not only method of revascularization but also general condition of the patient, the factors influencing peri-operative risk and optimal pharmacotherapy should be taken into account. Therefore establishment of the heart team is crucial when choosing the most suitable method of invasive treatment of left main disease.
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Krzych et al. (2012) conducted a review in Unprotected left main disease. Revascularization methods was evaluated. Optimal treatment of left main disease requires considering the revascularization method, patient condition, peri-operative risk, and pharmacotherapy, making a heart team crucial.
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