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Percutaneous intervention of unprotected left main coronary: St. Lukes Heart Institute experience.


 Dalangin, Francisco ,
 Posas, Fabio Enrique,
 Del Carmen, Antonio ,
 Miranda, Ariel A

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Publication Type
Philippine Heart Association 36th Annual Convention


INTRODUCTION AND OBJECTIVES: Coronary artery Bypass Graft (CABG) surgery is still the gold standard for treatment of Left Main Coronary Artery (LMCA) stenosis. However, the development of better percutaneous techniques coupled with the advancement in stents and support devices has allowed the successful percutaneous revascularization of LMCA disease as demonstrated by a number of multi-center clinical trials. The aim of the study is to present our initial experience with unprotected LMCA-PCI and to compare and contrast our data with that of contemporary studies
PATIENTS AND METHODOLOGY: Descriptive study of a historic cohort of patients who underwent LMCA-PCI at the St. Lukes Heart Institute from January 2001 to January 2005
RESULTS: A total of fifteen (15) patients were included. Most of the patients had adequate LV function (86 percent) and had at least three (3) cardiovascular risk factors present prior to the procedure. Seven patients had bifurcation lesions, three of which had T-stents, two had Crush stents and one had double barrel stent. The rest of the patients had single stents implanted. All patients received sirolimus-eluting stents. Five patients had IVUS studies and one patient underwent atherectomy before stent implantation. Five patients presented with acute MI wherein one patient needed IABP support during the procedure. One patient suffered ventricular arrhythmias post-stenting and eventually died. While two patients died during the follow-up period because of non-cardiac causes. No other major adverse cardiac events were noted. The remainder of the patients noted improvement in functional capacity and had less recurrence of symptoms
CONCLUSION: Our initial experience regarding LMCA-PCI showed very promising results. The most favorable outcomes came from patients who had acceptable age, and adequate ejection fraction. The use of sirolimus-stents, IVUS guidance, and new bifurcation stenting techniques further increased procedural success and decreased procedure-related mortality. (Author)

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Philippine Council for Health Research and Development Library Abstract Print Format

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