Role of PCI in patients with unprotected left main coronary artery disease / Wasseem Amin Wahba ; Supervised Khaled Ali Sorour , Hossam Kandil , Hussien Heshmat Kassem

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: The left main coronary artery (LMCA) is a relatively large-caliber vessel, supplying more than 75% of the coronary blood flow to the left ventricle. LMCA disease, angiographically defined as > 50% diameter stenosis, occurs in 4- 10% of patients undergoing coronary angiography, and places patients at risk of life threatening conditions. The survival benefit of the bypass surgery compared with medical therapy was first shown in the Veterans Administration trial and confirmed in subsequent studies. Over the past several decades, however, there has been a tremendous improvement in coronary artery revascularization not only in CABG but also in percutaneous coronary intervention (PCI). Several groups have shown that LMCA stenting is feasible and safe, and, in low risk patients, it is associated with acceptable long-term outcomes. Objectives:This study evaluated the demographic variations of the Egyptians with LMCA disease, also estimated the percentage of patients with significant left main coronary artery disease undergoing surgical revascularization versus PCI in the Egyptian population, and determined the mortality rates in the patients with LMD undergoing surgical revascularization versus PCI in the Egyptian population. Methods: This study included 265 patients who presented to the cardiology department of Kasr El-Aini University Hospital with documented significant left main coronary artery disease over a period of three years and followed up for another year post procedure. Subjects included in this study were classified into two groups. The first group consisted of 95 patients with the diagnosis of LMD underwent CABG. The second group consisted of 170 patients with the diagnosis of LMD underwent PCI to LM

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