SHORT TERM OUTCOMES OF LEFT MAIN CORONARY ARTERY STENTING

Abstract

Objective: To determine the short term outcomes of left main coronary artery stenting and whether stenting of unprotected left main coronary artery (ULMCA) stenosis in carefully selected patients with normal left ventricular (LV) systolic function is safe and thus may provide an alternative treatment to coronary artery bypass graft (CABG).

Study Design: Descriptive study.

Place and Duration of Study: Army Cardiac Center Lahore from Jan 2016 to Jun 2017.

Patients and Methods: A total of 50 patients with ULMCA stenosis who were treated with stent angioplasty by using drug eluting stents were evaluated. Patients were followed closely with monthly telephone interviews and follow-up angiography was done at 3 months. The occurrence of major in hospital complications like death, fatal and non fatal myocardial infarction (MI), acute or subacute stent thrombosis and urgent CABG in these patients were recorded. Along with this occurrence of angiographic restenosis and target vessel revascularization rates
were recorded after 3 months of angiographic followup.

Results: The procedural success rate was 100%. Major events like acute or subacute stent thrombosis, death, fatal or nonfatal MI, urgent CABG didn’t occur in any patient. Three months follow-up angiography was performed in 20 of 50 patients. Other patients (without angiographic follow-up) remained asymptomatic. All of 20/50 patients had patent stents of left main coronary artery and hence target vessel revascularization rate was zero in these patients.

Conclusion: Stenting of ULMCA stenosis may be a safe and effective alternative to CABG in carefully selected patients.