Showkathali Refai, Yalamanchi Radha Priya
Department of Cardiology, Apollo Main Hospital Chennai, India.
Interv Cardiol. 2023 May 26;18:e20. doi: 10.15420/icr.2023.02. eCollection 2023.
The majority of the left ventricular myocardium is supplied by the left main coronary artery. Atherosclerotic obstruction of the left main coronary artery therefore leads to significant myocardial jeopardy. Coronary artery bypass surgery (CABG) has been the gold standard for left main coronary artery disease in the past. However, advancements in technology have established percutaneous coronary intervention (PCI) as a standard, safe and reasonable alternative to CABG, with comparable outcomes. Contemporary PCI of left main coronary artery disease comprises careful patient selection, accurate technique guided by either intravascular ultrasound or optical coherence tomography and - if necessary - physiological assessment using fractional flow reserve. This review focuses on current evidence from registries and randomised trials comparing PCI with CABG, procedural tips and tricks, adjuvant technologies and the triumph of PCI.
大部分左心室心肌由左冠状动脉主干供血。因此，左冠状动脉主干的动脉粥样硬化性阻塞会导致严重的心肌危险。在过去，冠状动脉旁路移植术（CABG）一直是治疗左冠状动脉主干疾病的金标准。然而，技术的进步已使经皮冠状动脉介入治疗（PCI）成为CABG的一种标准、安全且合理的替代方法，二者疗效相当。当代对左冠状动脉主干疾病的PCI包括仔细的患者选择、由血管内超声或光学相干断层扫描引导的精确技术，以及必要时使用血流储备分数进行的生理评估。本综述重点关注来自登记研究和随机试验的当前证据，这些研究比较了PCI与CABG、手术技巧、辅助技术以及PCI的优势。
