Hsiao-Yang Cheng1, Kuang-Te Wang1, Wen-Hsiung Lin1, Jui-Peng Tsai2, Yung-Tzi Chen1. 1. Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung; 2. Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung; ; Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: To investigate the safety and outcome of percutaneous coronary intervention for left main coronary artery disease in hospital without on-site cardiac surgery. METHODS: Between January 2007 and December 2010, all patients diagnosed with left main coronary artery disease and refused coronary artery bypass graft surgery in our hospital or a tertiary center, were enrolled. Data including clinical course, angiographic characteristics, and 1- and 3-years outcomes were recorded and analyzed. RESULTS: Seventy patients (mean age 73.4 ± 10.2 years, 47 male, 23 females) were treated with a mean SYNTAX score of 34.8 ± 12.6 and EuroSCORE of 6.7 ± 3.3. Thirty-two (45.7%) patients had stable angina, 35 (50.0%) had unstable angina/non ST-elevation myocardial infarction, and 3 (4.3%) had ST-elevation Myocardial infarction. Forty-three (61.4%) patients received a single-stent, 26 (37.1%) received two-stents, and 1 (1.4%) received balloon angioplasty. No procedure-related mortalities were noted and no emergency coronary artery bypass graft surgery was required. In the 3-year follow-up period, 2 (2.9%) patients had non-fetal myocardial infarction, 11 (15.7%) had left main target lesion revascularization. The major adverse cardiac and cerebrovascular events rates were 24.3% at 1 year and 37.1% at 3-years. The all-cause mortality rate was 41.4% (29 patients), including 18 (25.7%) cases of septic shock, 7 (10.0%) of sudden cardiac death, 2 (2.8%) of hypovolemic shock due to upper gastrointestinal bleeding, 1 (1.4%) of terminal stage malignancy, and 1 (1.4%) of suffocation at 3 years. CONCLUSIONS: Percutaneous coronary intervention for patients with left main coronary artery disease was found to be a safe and effective strategy in our hospital without on-site cardiac surgery. KEY WORDS: Incomplete revascularization; Left main coronary artery (LM); No cardiac surgery; Percutaneous coronary intervention (PCI).
BACKGROUND: To investigate the safety and outcome of percutaneous coronary intervention for left main coronary artery disease in hospital without on-site cardiac surgery. METHODS: Between January 2007 and December 2010, all patients diagnosed with left main coronary artery disease and refused coronary artery bypass graft surgery in our hospital or a tertiary center, were enrolled. Data including clinical course, angiographic characteristics, and 1- and 3-years outcomes were recorded and analyzed. RESULTS: Seventy patients (mean age 73.4 ± 10.2 years, 47 male, 23 females) were treated with a mean SYNTAX score of 34.8 ± 12.6 and EuroSCORE of 6.7 ± 3.3. Thirty-two (45.7%) patients had stable angina, 35 (50.0%) had unstable angina/non ST-elevation myocardial infarction, and 3 (4.3%) had ST-elevation Myocardial infarction. Forty-three (61.4%) patients received a single-stent, 26 (37.1%) received two-stents, and 1 (1.4%) received balloon angioplasty. No procedure-related mortalities were noted and no emergency coronary artery bypass graft surgery was required. In the 3-year follow-up period, 2 (2.9%) patients had non-fetal myocardial infarction, 11 (15.7%) had left main target lesion revascularization. The major adverse cardiac and cerebrovascular events rates were 24.3% at 1 year and 37.1% at 3-years. The all-cause mortality rate was 41.4% (29 patients), including 18 (25.7%) cases of septic shock, 7 (10.0%) of sudden cardiac death, 2 (2.8%) of hypovolemic shock due to upper gastrointestinal bleeding, 1 (1.4%) of terminal stage malignancy, and 1 (1.4%) of suffocation at 3 years. CONCLUSIONS: Percutaneous coronary intervention for patients with left main coronary artery disease was found to be a safe and effective strategy in our hospital without on-site cardiac surgery. KEY WORDS: Incomplete revascularization; Left main coronary artery (LM); No cardiac surgery; Percutaneous coronary intervention (PCI).
Authors: Enno Boudriot; Holger Thiele; Thomas Walther; Christoph Liebetrau; Peter Boeckstegers; Tilmann Pohl; Bruno Reichart; Harald Mudra; Florian Beier; Brigitte Gansera; Franz-Josef Neumann; Michael Gick; Thomas Zietak; Steffen Desch; Gerhard Schuler; Friedrich-Wilhelm Mohr Journal: J Am Coll Cardiol Date: 2011-02-01 Impact factor: 24.094
Authors: Patrick W Serruys; Andrew T L Ong; Lex A van Herwerden; J Eduardo Sousa; Adib Jatene; Johannes J R M Bonnier; Jacques P M A Schönberger; Nigel Buller; Robert Bonser; Clemens Disco; Bianca Backx; Paul G Hugenholtz; Brian G Firth; Felix Unger Journal: J Am Coll Cardiol Date: 2005-08-16 Impact factor: 24.094