Left main coronary artery stent application: early and late period results

Percutaneous coronary intervention of left main coronary artery (LMCA) in the setting of acute myocardial infarction or in patients with cardiac and non-cardiac diseases that increase mortality rate after coronary artery bypass surgery has been proposed as "last resort option" and these patients can be managed safely with intracoronary stenting. In this study, we evaluated the short- and long-term follow-up outcomes of patients with left main coronary lesions underwent stent implantation in our clinic. A total of 15 patients (12 M, 3 F; mean age 58 +/- 13 years) with left main coronary stenosis considered at high risk for surgical treatment or patients with acute myocardial infarction with LMCA stenosis were enrolled into the study and treated by stenting. Eight patients were treated for unstable angina (53%), 2 had stable angina (13%) and 5 had acute myocardial infarction (33%). Three patients had "protected" and 12 patients "unprotected" LMCA stenosis. An intraaortic balloon pump was used in 6 (40%) and pacemaker in 4 (26.6%) patients. In the study group the short and long-term mortality rate was 4 (26.6%). Among 13 survived cases, signs of left ventricular failure developed in 2 patients (15.3%). Restenosis rate on control coronary angiography was revealed in 28.8% of cases. Utilization of elective stenting in patients at high surgical risk with protected and unprotected LMCA lesions and percutaneous coronary intervention in patients with acute myocardial infarction and left main coronary artery lesions could be appraised as an alternative to surgical treatment approaches.