Acute and Long Term Outcomes of Coronary Intervention in Unprotected Left Main Lesions

Introduction : Significant left main coronary artery stenosis jeopardizes the entire myocardium of the left ventricle and has the worst prognosis of any form of coronary artery disease. Coronary-artery bypass grafting (CABG) has been considered as the standard therapeutic approach for such patients. There are limited data on the safety and effectiveness of percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery disease. In this study we have reported our experience on early, intermediate and long term results of LMC intervention. Methods: From Dec. 2007 to Mar. 2012, PCI with drug eluted stent (DES) or in some cases by a bare stent was performed on de-novo lesions of unprotected left main coronary artery in 50 patients. The inclusion criteria were: patients having refused CABG but with favorable anatomy for stenting; patients with poor general condition or comorbidity whom were refused by the cardiac surgeon and emergent patients for whom CABG was not accessible. Results: The angiographic and procedural success rate was 100%. Four patients died, two because of severe heart failure, the third due to noncardiac etiology, and the fourth due to probable stent thrombosis. We have one target lesion revascularization (TLR=2%) and no reinfarction was occurred. Conclusion: Routine DES implantation in unprotected left main disease seems a feasible and safe method with favorable outcomes.