Multivessel Off-Pump Revascularization in Patients with Significant Left Main Coronary Artery Stenosis:. Early and Midterm Outcome Analysis

Abstract

Multivessel off-pump revascularization in patients with severe left main disease is a safe and effective alternative to conventional bypass grafting and conveys a survival benefit.

Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis

“…This finding, in accordance with the current literature, 17,20 is quite important in planning any future trial in which the use of off-pump revascularization should be encouraged.…”

“…1 Some retrospective studies evaluating surgical treatment for this disease reported an in-hospital mortality rate varying from 1.7% to 7.0% and a 1-year mortality rate of 6% to 14%. [17][18][19][20] Conversely, the treatment of LMCA stenosis by PCI is still debated. In these patients, PCI has thus far been performed only in exceptional cases, albeit with positive results.…”

Long-Term Outcomes of Intervention for Unprotected Left Main Coronary Artery Stenosis Coronary Stenting vs Coronary Artery Bypass Grafting

“…Finally, the relatively low penetration of IABP support and off-pump CABG were also probably attributable to the higher perioperative cardiovascular event rate. 23,24 Complete Revascularization by CABG vs TLR at ULMCA by PCI The results of the current study showed that the PCI group had a higher incidence of TLR, as well as any revascularization, without increased MACCE. Many studies have proven that patients with complete surgical revascularization have better clinical outcomes than those with incomplete surgical revascularization.…”

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“…Additionally, a smaller fraction of OPCAB patients require inotropic or intra-aortic balloon pump support when compared to their propensity-matched CABG counterparts. A marked decrease in the need for transfusion of blood, platelets and fresh frozen plasma has also been noted (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34).…”