Comparison of Stenting with Minimally Invasive Bypass Surgery for Stenosis of the Left Anterior Descending Coronary Artery

Minimally invasive bypass surgery and coronary stenting are both alternatives to standard bypass surgery for the management of stenosis of the proximal left anterior descending artery. In this randomized trial, stenting provided excellent short-term results with fewer periprocedural events, but minimally invasive surgery proved better at six months in terms of freedom from angina and the need for repeated procedures. Stenting provided excellent short-term results, but minimally invasive surgery proved better at six months and does not require cardiopulmonary bypass. High-grade stenosis of the proximal left anterior descending coronary artery in patients with single-vessel disease is associated with a significantly worse prognosis than lesions at any other location. 1 , 2 Both percutaneous transluminal coronary angioplasty and coronary-artery bypass grafting have been shown to improve symptoms in such patients. 3 , 4 In several studies, the incidence of medium-term adverse events and the proportion of patients requiring repeated revascularization of the target lesion were consistently higher after balloon angioplasty than after conventional coronary-artery bypass grafting in patients with single-vessel 5 , 6 or multivessel 7 – 9 disease. With the introduction of intracoronary stents, however, the rate of . . .