This Article Full Text Full Text (PDF) View Talk Back on Cardiosource Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Brinker, J. Search for Related Content PubMed PubMed Citation Articles by Brinker, J.

STATE-OF-THE-ART PAPER AND COMMENTARY

The Left Main Facts: Faced, Spun, But Alas Too Few

The Johns Hopkins Hospital, Baltimore, Maryland.

Manuscript received October 10, 2007; accepted October 24, 2007.

^_* Reprint requests and correspondence: Dr. Jeffrey A. Brinker, CMSC 501, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland 21287. (Email: jbrinker{at}jhmi.edu).

Bypass surgery has been shown to prolong life in patients with significant left main stenosis compared with medical therapy and is the current standard of care. Recent registry data suggest that stenting may offer intermediate-term results similar to surgery, although with a greater need for repeat revascularization. Drug-eluting stents appear to improve the outcomes of stenting. Over 20% of patients with left main disease currently receive stents, and there is need for ongoing randomized controlled trials to validate this approach. It is essential that such patients receive balanced counseling as to revascularization options.

Abbreviations and Acronyms   BMS = bare-metal stent(s)   CABG = coronary artery bypass grafting   DES = drug-eluting stent(s)   ITA = internal thoracic artery   LAD = left anterior descending coronary artery   LM = left main coronary artery   PCI = percutaneous coronary intervention   ST = stent thrombosis

This article has been cited by other articles:

				D.-W. Park, K. B. Seung, Y.-H. Kim, J.-Y. Lee, W.-J. Kim, S.-J. Kang, S.-W. Lee, C. W. Lee, S.-W. Park, S.-C. Yun, et al. Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease: 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry J. Am. Coll. Cardiol., July 6, 2010; 56(2): 117 - 124. [Abstract] [Full Text] [PDF]

				C. Girasis, P. W. Serruys, Y. Onuma, A. Colombo, D. R. Holmes Jr, T. E. Feldman, E. J. Bass, K. Leadley, K. D. Dawkins, and M.-C. Morice 3-Dimensional Bifurcation Angle Analysis in Patients With Left Main Disease: A Substudy of the SYNTAX Trial (SYNergy Between Percutaneous Coronary Intervention With TAXus and Cardiac Surgery) J. Am. Coll. Cardiol. Intv., January 1, 2010; 3(1): 41 - 48. [Abstract] [Full Text] [PDF]

				F. G. Kushner, M. Hand, S. C. Smith Jr, S. B. King III, J. L. Anderson, E. M. Antman, S. R. Bailey, E. R. Bates, J. C. Blankenship, D. E. Casey Jr, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines J. Am. Coll. Cardiol., December 1, 2009; 54(23): 2205 - 2241. [Full Text] [PDF]

				F. G. Kushner, M. Hand, S. C. Smith Jr, S. B. King III, J. L. Anderson, E. M. Antman, S. R. Bailey, E. R. Bates, J. C. Blankenship, D. E. Casey Jr, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation, December 1, 2009; 120(22): 2271 - 2306. [Full Text] [PDF]

				R. P. Akhtar, M. S. Naqshband, A. R. Abid, Z. Tufail, A. Waheed, and J. S. Khan Surgery for Chronic Total Occlusion of the Left Main Stem: A 10-Year Experience Asian Cardiovasc Thorac Ann, October 1, 2009; 17(5): 472 - 476. [Abstract] [Full Text] [PDF]