Why the study?
While revascularization improves prognosis in chronic coronary syndrome with significant LMCA disease, the optimal strategy between CABG surgery and PCI remains debated.
This review summarizes the evidence on revascularization strategies (PCI vs CABG) and procedural challenges for patients with left main coronary artery disease.
Review of left main strategies informs decisions cautiously; leaves open optimal PCI vs CABG selection pending new trials.
Left main coronary artery (LMCA) disease has been reported in up to 10% of all patients with coronary artery disease (CAD) and in the majority of cases are associated with severe three-vessel CAD. Among patients with chronic coronary syndrome revascularization of significant LMCA disease improves prognosis, while there is a debate about which revascularization strategy, CABG surgery or percutaneous coronary interventions to use. We do a review of the available evidence about the impact of LMCA lesions on patient prognosis according to CAD extension and clinical presentation, the outcome after percutaneous or surgical revascularization, the procedural challenges of LMCA PCI and the available armamentarium to optimally treat this relevant population.
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Chiarito et al. (2020) studied this question.
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