PCI VERSUS CABG: INTERVENTIONAL CARDIOLOGISTS CHOICE TO TREAT LMCA DISEASE IN A BETTER, SAFER AND ACCEPTABLE WAY

Objective: Interventional cardiologists have always faced the issue of LMCA critical stenosis. Conventionally, CABG is carried out in the management of patients; but, more frequent use of PCI (Percutaneous Coronary Intervention) have been observed but scarce literature is available about the utilization of PCI. We aimed to determine the rate of technical success and safety of the stenting of percutaneous LMCA.

Methods: We studied 53 patients in our research at Services Hospital, Lahore in the timeframe of February 2016 to March 2017. We included all the patients who experienced coronary angiogram and diagnosed with an isolated LMCA or coexisting ostial LAD artery disease. All the cases having any previous surgical management of CAD and dialysis cases (renal disrders) were not made a part of this research. Patients were briefed about the CABG and PCI regarding their benefits and shortcomings. We considered all those cases who opted PCI and managed all these patients for stenting of percutaneous LMCA with or without the help of stenting of ostial LAD stenting.

Results: A total of 72 patients were diagnosed with the disease of LMCA in the course of angiogram; whereas, only 15 patients chose CABG, inclusion criteria were not fulfilled by four patients, therefore, our final research sample was restricted to 53 patients. Patients were observed with a mean age of (55.45 ± 10.275) years. Acute coronary syndrome and stable angina were reported in respectively 29 and 22 patients. All patients had technically successful PCI with stenting. Only one mortality was reported after three months of PCI and no other death case was reported.

Conclusion: PCI has better, safer and acceptable outcomes with a better technical success to LMCA critical stenosis.

Keywords: CABG (Coronary Artery Bypass Graft), LMCA (Left Main Coronary Artery). CAD (Coronary Artery Disease), PCI (Percutaneous Coronary Intervention) and LAD (Left Anterior Descending).