Left Main Stem Disease Litfl

Early identification of left main coronary artery lmca disease is critical because acute occlusion can cause rapid hemodynamic and electrical deterioration 1 2. Many years ago the coronary artery surgery study cass registry demonstrated the superiority of coronary artery bypass grafting cabg over medical therapy with a 5 year mortality reduction from 43 to 16 in. Can be performed off pump or on pump.

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Lmca Occlusion St Elevation In Avr Litfl Ecg Library Diagnosis

One patient died in one year follow up because of noncompliance for medication.

Left main stem disease litfl. During 1970 1984 early mortality was 5 8 in patients with left main stenosis vs1 5 in patients without left main stenosis. Usually requires severe stenosis 70 with left main stem or triple vessel disease. An early and simple predictor of severe left main and or three vessel disease in patients with non st segment elevation acute coronary syndrome. Left main stem lms disease is identified in up to 5 of diagnostic angiography cases.

Although coronary balloon angioplasty is an established treatment for patients with coronary artery disease the results of balloon angioplasty of unprotected left main coronary artery lmca stenosis have been disappointing because of the high mortality rate in both in hospital 9 1 and follow up periods 1 current in hospital mortality after initial coronary artery bypass graft surgery. A total of 40 patients with distal left main stem lesion included in our study their age range between 45 75 years with a mean sd of 59 4 5 years 25 were male 15 female. The results of surgery of left main stenosis were reviewed by jonsson. They compared 1888 patients who underwent cabg for left main stenosis with 8759 patients who had cabg for coronary disease without left main disease.

No improved survival seen in patients with single or double vessel disease. 1 it has major prognostic significance due to the proportion of myocardium at risk. Kosuge m kimura k ishikawa t ebina t shimizu t hibi k et al. Improved survival seen in those with poor left ventricular function.

2011 feb 15 107 4 495 500 abstract. Lmca insufficiency due to critical stenosis of the left main artery is important to recognize because these patients can progress to complete occlusion and are likely to require surgical intervention such as cabg 3. Predictors of left main or three vessel disease in patients who have acute coronary syndromes with non st segment elevation.