Left Main Stem Disease Treatment

Left main coronary artery lmca disease remains an important risk factor for increased mortality and morbidity at all stages of diagnosis and treatment of coronary artery disease.

Left main stem disease treatment. Please explain about mild diseases of proximal lad also advise about the dietary modifications required in these conditions. Due its critical location the lms supplies blood to two thirds of the left ventricle acute occlusion is rapidly fatal and medically managed lms disease carries a poor prognosis with a one year mortality of approximately 20 1. They reiterate that cabg remains the gold standard for the treatment of the unprotected left main coronary artery. Coronary artery bypass grafting has been the gold standard for treatment of left main disease.

As such it poses diagnostic and management challenges. A coronary artery bypass graft cabg is a surgical procedure used to treat coronary heart disease. However advancements in percutaneous coronary intervention such as drug eluting stents and techniques risk stratification and intravascular ultrasound have. Left main coronary artery lmca disease remains an important risk factor for increased mortality and morbidity at all stages of diagnosis and treatment of coronary artery disease.

Coronary artery bypass surgery has been the definitive treatment choice. A mild disease in lad means that the left anterior descending artery which is one of the 3 arteries supplying blood to a very important area of the heart anterior wall and the interventricular septum has fatty deposits in the wall at a point which is not. Left main coronary artery disease is of particular importance because left main stem lms is responsible for 84 of the blood supplied to left ventricle in case of left coronary dominant system the patients with severe lms stenosis have a very high risk of major cardiovascular events because of the extent of ischaemic myocardium. In 2005 the acc aha task force on practice guidelines updated their guidelines for percutaneous intervention.

They provided extensive guidance for patients with left main stem disease. Significant left main stem lms stenosis is amongst the most feared findings during work up of suspected coronary artery disease. Left main stem pathology is often silent with unpredictable presentation. In fact even antedating our current era of evidence based optimal medical therapy those with 50 to 70 lm stenosis or with preserved left ventricular lv function were found to have more favorable survival while receiving medical management alone 66 3 year survival compared with more severe lm disease 70 41 3 year survival or with reduced lv function.

A meta analysis of the seven major studies conducted between 1972 1984 by yusuf et al showed a 68 reduction in mortality at 5 years in patients who underwent cabg compared to medical therapy for left main disease. Left main disease is the blockage of the left main coronary artery. 5 7 even these older. This study aims to compare two treatments.

As such it poses diagnostic and management challenges.