Left Main Coronary Artery Lesion: Surgical Revascularization or Percutaneous Coronary Intervention: An Update in Light of the Latest Studies
Driss Britel
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
Soumaila Nikièma *
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
Désiré Massimbo
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
Emmanuel Graham
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
Aatif Benyass
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
Zouhair Lakhal
Department of Cardiology, Mohammed V Military Instruction Hospital, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Coronary artery bypass grafting (CABG) has been considered to be the technique for revascularisation of complex coronary artery disease such as left anterior descendy coronary artery. The advent of percutaneous coronary intervention (PCI) modified this attitude, particularly with the improvement in technical modalities and human experience, making multi-vessel and left main coronary artery (LMCA) lesions technically feasible by PCI. Several studies have been carried out over the years to determine the optimal method of revascularisation of patients with LMCA lesions taking into account the occurrence of major cardiovascular events. The recent studies concerning this topic are the SYNTAX, the NOBLE and the EXCEL studies. Bypass surgery remains the first choice. PCI is an interesting alternative for patients with uncomplicated coronary disease and a low syntax score.
Keywords: Left coronary artery, angioplasty, bypass grafting