Interv Akut Kardiol. 2003;2(1):18-22

The angioplasty of left main coronary artery in high risk patients Objective of the study

Michael Želízko, Bronislav Janek, Marek Hrnčárek, Jiří Kettner, Vladimír Pořízka, Vladimír Karmazín

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

to assess efficacy of coronary intervention of left main coronary artery in the group of patients during 1995-2002



Methods: retrospective analysis of the registry of coronary interventions in the Department of Cardiology of IKEM. The group of 50 patients who underwent percutaneous coronary intervention (PCI) of left main coronary artery was evaluated.

Results: based on clinical indication to intervention we evaluated 4 subgroups of patients.

I. the group of patients with an acute myocardial infarction (n=22): in hospital mortality was 55%, mortality of patients resuscitated during their intervention was 69%, mortality of patients with total occlusion of left main was 77%. Favorable outcome was among patients who did not require cardiac massage during intervention (mortality of 17%) and did not suffer from total occlusion of left main (mortality of 23%).

II. The group of patients with unstable angina/NSTEMI (n=8): uncomplicated hospitalization stage in all patients

III. Inoperable patients after previous revascularization operation of myocardium (n=16): the character of intervention is palliative, complex lesions require use of alternative methods (2× rotablation, 1× DCA, 7× IVUS quided stent implantation, 8x PCI of further lesions). Hospitalization time was uncomplicated.

IV. Elective PTCA of left main (n=4) with uncomplicated course.

Conclusion: Patients with left main coronary artery stenosis represent a very heterogeneous group. Prognosis in patients with acute myocardial infarction is unfavorable in those where a total occlusion occurs what is being usually accompanied by cardiac arrest requiring cardiopulmonary resuscitation. In other indications, the catheterization procedure is safe. The long term outcome of coronary intervention was favorable in our group of patients. The subsequent angiography is necessary in order to detect restenosis (in 18%).

Keywords: percutaneous coronary inervention, left main coronary artery, acute myocardial infarction, coronary artery bypass graft surgery.

Published: December 31, 2003  Show citation