Revascularization for Unprotected Left Main Coronary Artery Disease: An Evolution in Clinical Decision Making

Author:

Kandzari David E.,Ormiston John A.

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine

Reference43 articles.

1. •• Kandzari DE, Colombo A, Park SJ, et al. Revascularization for unprotected left main disease: evolution of the evidence basis to redefine treatment standards. J Am Coll Cardiol. 2009;54:1576–88. This position paper from the American College of Cardiology (ACC) Interventional Council summarizes the practical and clinical trial issues with ULM PCI. The manuscript also provides a comprehensive summary of comparative ULM PCI versus CABG trials.

2. •• Kushner FG, Hand M, Smith SC, 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 2008;117:261–95. This revision of the ACC/American Heart Association guidelines advanced the performance of ULM PCI from a class III to class IIb recommendation. In addition, routine angiographic surveillance following ULM PCI is no longer recommended.

3. •• Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association for Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2010 Aug 29. [Epub ahead of print]. This revision of the ESC guidelines advanced the performance of ULM PCI to class IIa or IIb recommendation, depending upon lesion complexity. In addition, the guidelines place emphasis on the role of the SYNTAX score and the collaboration between interventionalists and surgeons (Heart Team) in clinical decision making.

4. Park SJ, Park DW. Percutaneous coronary intervention with stent implantation versus coronary artery bypass surgery for treatment of left main coronary artery disease. Is it time to change guidelines? Circ Cardiovasc Intervent. 2009;2:59–68.

5. Boudriot E, Thiele H, Walther T, et al. Randomized comparison of percutaneous coronary intervention with sirolimus-eluting stents versus coronary artery bypass grafting in unprotected left main stem stenosis. J Am Coll Cardiol. 2011;57:538–45.

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