Clinical outcome in patients with intermediate or equivocal left main coronary artery disease after deferral of surgical revascularization on the basis of fractional flow reserve measurements

2006 ◽  
Vol 152 (1) ◽  
pp. 156.e1-156.e9 ◽  
Author(s):  
Michael Lindstaedt ◽  
Aydan Yazar ◽  
Alfried Germing ◽  
Markus K. Fritz ◽  
Tim Holland-Letz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcome ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Fractional Flow ◽  
Surgical Revascularization ◽  
Flow Reserve ◽  
Main Coronary Artery Disease ◽  
Artery Disease

scholarly journals Lesion left main coronary artery and / or multivessel coronary artery disease

2021 ◽  
pp. 28-32
Author(s):  
V. A. Skybchyk ◽  
Y. P. Melen
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Invasive Coronary Angiography ◽  
Myocardial Revascularization ◽  
Clinical Signs ◽  
Left Main ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease

The article describes the clinical and electrocardiograph|y features of the lesion left main coronary artery (LMCA). LMCA stenosis of more than 50% allows to classificated such patients as a high risk of sudden death, which occurs 3-4 times more often compared with coronary artery disease in other localizations. Another feature characteristic of this category of patients is the presence of multifocal atherosclerosis (MFA). In patients without carotid stenosis, LMCA lesions are detected in 5% of cases, while in patients with MFA (with lesions of the carotid arteries) - in 40%. Despite some clinical signs that allow the patient to suspect the presence of LMCA, the most informative and reliable method is invasive coronary angiography (CAG). Evaluation of CAG using fractional flow reserve (FFR) and intravascular ultrasound (IVUS) help to improve the diagnosis of the degree of LMCA stenosis, assess the nature of the plaque, the true diameter of the vessel and is an important step towards early myocardial revascularization. The article also presents the clinical analysis of lectrocardiogram with lesions of LMCA and multivessel lesions of the coronary arteries (three vessels or more).

Early and Mid-Term Clinical Outcome of Emergency PCI in Patients with STEMI due to Unprotected Left Main Coronary Artery Disease

2012 ◽  
Vol 25 (3) ◽  
pp. 215-222 ◽  
Author(s):  
ANTONIO PARMA ◽  
ROSARIO FIORILLI ◽  
FRANCESCO DE FELICE ◽  
FRANCESCO CHINI ◽  
PAOLO GIORGI ROSSI ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcome ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Main Coronary Artery Disease ◽  
Artery Disease

scholarly journals Physiology-Based Revascularization of Left Main Coronary Artery Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Peter Kayaert ◽  
Mathieu Coeman ◽  
Sofie Gevaert ◽  
Michel De Pauw ◽  
Steven Haine
Keyword(s):  
Coronary Artery Disease ◽  
Left Main Coronary Artery ◽  
Critical Importance ◽  
Left Main ◽  
Fractional Flow ◽  
Left Main Disease ◽  
Flow Reserve ◽  
Main Coronary Artery Disease ◽  
Physiological Assessment ◽  
Artery Disease

It is of critical importance to correctly assess the significance of a left main lesion. Underestimation of significance beholds the risk of inappropriate deferral of revascularization, whereas overestimation may trigger major but unnecessary interventions. This article addresses the invasive physiological assessment of left main disease and its role in deciding upon revascularization. It mainly focuses on the available evidence for fractional flow reserve and instantaneous wave-free ratio, their interpretation, and limitations. We also discuss alternative invasive physiological indices and imaging, as well as the link between physiology, ischemia, and prognosis.

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