Short‐ and long‐term results of emergency and elective percutaneous interventions on left main coronary artery stenoses

Abstract

In this prospective study, we analyzed the short- and long-term outcomes of percutaneous interventions on significant left main coronary artery (LM) stenoses. Between January 1998 and June 2000, 18 patients underwent emergency interventions on unprotected LM stenoses (group 1), while 15 patients had elective interventions on protected LM stenoses (group 2). Despite a procedural success of 88.9% in group 1, event-free in-hospital and mortality rates were 50.0% and 38.9%. After 6.4 +/- 4.4 months of follow-up, late event-free survival and mortality rates were 33.3% and 38.9%. In group 2, procedural success was 100%, with 100% event-free in-hospital survival; late event-free survival and mortality rates were 93.3% and 0% after 6.7 +/- 4.1 months of follow-up. Emergency interventions on LM stenoses remain a procedure with high acute and mid-term mortality. In spite of the high rate of major adverse cardiac events, an acceptable long-term survival can be achieved.

Left main percutaneous intervention: The saga continues

“…Therefore, the study by Sperker et al [1] is of primary interest when one evaluates the results in those patients undergoing emergency percutaneous intervention for LM occlusive disease. In 11 of the 18 patients in group 1 who were noted to be in cardiogenic shock, 7 of the 11 either died as a procedural complication or while in hospital.…”

“…In this issue, Sperker et al [1] report on patients undergoing percutaneous intervention of the left main (LM) at their institution between January 1998 and June 2000. The patients have been divided into two groups: 18 patients (group 1) undergoing emergency intervention on unprotected LM stenoses and 15 patients (Group 2) undergoing elective intervention on protected LM stenoses.…”

“…Since bypass surgery is generally not performed, the interventionalist is faced with the difficult but not impossible task of intervention as salvage in these desperately ill patients. Therefore, the results in emergency intervention on the LM, as reported by Sperker et al [1], are helpful in shedding some light on this difficult problem.…”