Left Main Stem Disease

Diagnosis and management of significant lmcad continues to be a source of clinical apprehension and uncertainty.

Left main stem disease. 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. 1 with the adoption of coronary angiography as a routine diagnostic tool during the 1960s left main stem disease became increasingly recognized and patients with this condition were soon identified as a high risk group. But today if you have been diagnosed with left main disease you have options. In a patient with left main stem coronary disease does percutaneous stenting or cabg result in the best long term survival.

2 in fact during this early era performing coronary. Significant left main stem lms stenosis is amongst the most feared findings during work up of suspected coronary artery disease. Early identification of left main coronary artery lmca disease is critical because acute occlusion can cause rapid hemodynamic and electrical deterioration 1 2. Left main coronary artery disease lmcad portends higher prognostic risk as a result of the large myocardial territory at risk ranging from 75 to 100 depending on the dominance of the left coronary circulation.

If there is no patent bypass graft to the left anterior descending lad or circumflex artery the disease is then referred to as unprotected left main disease uplm. 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. A significant stenosis 50 of the left main is present in 4 to 6 of patients who have undergone coronary angiography. Atherosclerotic involvement of the left main stem was first described more than 100 years ago by herrick.

The left coronary artery abbreviated lca is an artery that arises from the aorta above the left cusp of the aortic valve and feeds blood to the left side of the heart it is also known as the left main coronary artery abbreviated lmca and the left main stem coronary artery abbreviated lms it is one of the coronary arteries. The physicians on the medical staff at baylor hamilton heart and vascular hospital have successfully treated patients with left main disease using percutaneous coronary intervention pci techniques with stents providing a rapid less invasive procedure and a faster hospital discharge and return to daily activities.