हृदय रोग एवं निदान

Percutaneous Coronary Intervention for Isolated Left Main Coronary Artery Disease: A Single Centre Experience

Abstract

Md. Moniruzzaman*, C M Shaheen Kabir, Abdullah Al Mamun, Aparajita Karim and Md. Saiful Islam

Objective: Isolated left main coronary artery disease (ILMCAD) is not a frequent one. Though coronary artery bypass graft surgery (CABG) was thinks to be the standard treatment for left main coronary stenosis (LMCA). However, in the real world scenario, multiple studies suggest that treatment of patients with isolated left main coronary artery disease (ILMCAD) with percutaneous coronary intervention (PCI) can be a safe and suitable option.

Methods: This prospective observational study was carried out for 1 year between ‘01^st February 2021 to 31^st January 2022’. A total of 10 patients presented with Angina or NSTEMI and whom CAG reveals isolated left main coronary artery diseases were enrolled for this study. PCI to Left Main Coronary Artery was done with newer generation DES for all of this patients and six months outcome was recorded.

Results: Mean age of the patients was 44.1± 6.6 years. Among them male was 7 (70%), female was 3 (30%). Hypertension (70%) was the most common risk factor followed by smoking (60%), dyslipidemia (60%), diabetes mellitus (50%) and positive family history for IHD (50%). Among the total of 10 patients, 07 (70%) patients had chronic stable angina and 03 (30%) patients had NSTEMI. Ostial left main was involved in 03 (30%) patients, shaft involvement in 03 (30%) patients, 02 (20%) distal left main disease and whole segment disease in 02 (20%) patients. Mean SYNTAX score was 11.1 ± 1.1 with majority of patients having low SYNTAX score. All patients were treated with newer generation DES implantation. The post procedural outcome was satisfactory in all patients. No patient developed any Major Adverse Cardiovascular Events (MACE) during the study period.

Conclusion: Left main PCI with newer generation DES can a suitable option with favorable outcome to treat the patients who have isolated left main coronary artery disease.