Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis

Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis

Authors

  • Jonathan Faculty of Medicine, Pelita Harapan University, Tangerang Regency, Banten, Indonesia
  • Ronald Faculty of Medicine, Tarumanagara University, Special Region of Jakarta, Indonesia

Keywords:

Percutaneous Coronary Intervention, Coronary Artery Bypass Grafting, Left Main Coronary Artery Stenosis

Abstract

Background: The literature on the management of left main coronary artery disease (LMCAD) through percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) reveals a complex interplay of efficacy, safety, and long-term outcomes. The introduction of advanced technologies, particularly drug-eluting stents (DES), has positioned PCI as a viable alternative to CABG, even in cases traditionally managed by surgical intervention. Literature Review: The findings from (Eifert et al., 2010) indicate a significant increase in the acceptance of PCI, with long-term survival rates being comparable to CABG in both single and multivessel cases. However, concerns arise regarding the higher rates of recurrent symptoms and the necessity for repeat operations following PCI, which may question its long-term efficacy, particularly in the context of LMCAD. Conclusion: In conclusion, the body of literature supports the notion that both PCI and CABG are viable treatment options for LMCAD, with each approach offering distinct advantages and limitations. The decision-making process should be individualized, taking into account patient-specific factors, including age, comorbidities, and the anatomical complexity of coronary lesions. Ongoing research and longer follow-up studies are essential to further elucidate the long-term implications of these interventions and to refine clinical guidelines for the management of LMCAD.

References

Eifert, S., Mair, H., Boulesteix, A. L., Kilian, E., Adamczak, M., Reichart, B., & Lamm, P., 2010. Mid-term outcomes of patients with PCI prior to CABG in comparison to patients with primary CABG. ncbi.nlm.nih.gov

Ikonomou, D. & Triantafyllou, K., 2018. The Contemporary Role of Percutaneous Coronary Intervention in Left Main Disease Management. [PDF]

Spinthakis, N., Farag, M., A Gorog, D., Prasad, A., Mahmood, H., Gue, Y., Wellsted, D., Nabhan, A., & Srinivasan, M., 2018. Percutaneous coronary intervention with drug-eluting stent versus coronary artery bypass grafting : A meta-analysis of patients with left main coronary artery disease. [PDF]

José Negreiros de Andrade, P., Luiz de Alencar Araripe Falcão, J., de Alencar Araripe Falcão, B., & Alexandre Lima Rocha, H., 2019. Stent versus Coronary Artery Bypass Surgery in Multi-Vessel and Left Main Coronary Artery Disease: A Meta-Analysis of Randomized Trials with Subgroups Evaluation. ncbi.nlm.nih.gov

R. Khan, M., T. Kayani, W., Ahmad, W., Manan, M., S. Hira, R., Hamzeh, I., Jneid, H., S. Virani, S., Kleiman, N., Lakkis, N., & Alam, M., 2019. Effect of increasing age on percutaneous coronary intervention vs coronary artery bypass grafting in older adults with unprotected left main coronary artery disease: A meta‐analysis and meta‐regression. ncbi.nlm.nih.gov

Ullah, W., Sattar, Y., Ullah, I., Susheela, A., Mukhtar, M., Chadi Alraies, M., A. Mamas, M., & L. Fischman, D., 2020. Percutaneous Intervention or Bypass Graft for Left Main Coronary Artery Disease? A Systematic Review and Meta-Analysis. ncbi.nlm.nih.gov

Park, S., Park, S. J., & Park, D. W., 2022. Percutaneous Coronary Intervention for Left Main Coronary Artery Disease: Present Status and Future Perspectives. ncbi.nlm.nih.gov

Almas, T., Afzal, A., Fatima, H., Yaqoob, S., Ahmad Jarullah, F., Ahmed Abbasi, Z., Farooqui, A., Jaffar, D., Batool, A., Ahmed, S., Sara Azmat, N., Afzal, F., Zafar Khan, S., & Fatima, K., 2022. Safety and efficacy of percutaneous coronary intervention versus coronary artery bypass graft in patients with STEMI and unprotected left main stem disease: A systematic review & meta-analysis. ncbi.nlm.nih.gov

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Published

2024-07-15

How to Cite

Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis (J. Jonathan & R. Ronald , Trans.). (2024). The Indonesian Journal of General Medicine, 2(4), 1-16. https://doi.org/10.70070/g9tv6075