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Left main coronary artery rotational atherectomy and stenting Nayak AK; Davis R; Reddy HK; Krishnan MS; Voelker DJ; Aggarwal KSouth Med J 2000[Apr]; 93 (4): 415-23BACKGROUND: Coronary artery bypass surgery is a difficult option in patients who are not candidates for bypass surgery and high-risk patients with critical left main coronary artery (LMCA) disease. We report outcomes and short-term follow-up of patients who had LMCA rotational atherectomy and/or stenting, assess the role of these interventions in protected and unprotected significant LMCA stenosis, and review the literature. METHODS: We reviewed the cases of seven men with critical LMCA stenosis for whom coronary artery bypass surgery was considered a high risk. Five patients had rotational atherectomy, one had coronary artery stenting, and one had both. RESULTS: In all cases, angiographic success was achieved, and symptoms were relieved. Six patients were discharged from the hospital in 3 to 6 days. One patient who had cardiogenic shock, respiratory failure, and acute renal failure before the procedure died of arrhythmia 4 days afterward. Another patient had elective coronary artery bypass graft surgery 3 weeks later for recurrent angina. Cardiac catheterization was repeated in 1 month for chest pain in three patients at 4 to 7 months follow-up, and none had progression of residual stenosis in the LMCA. CONCLUSIONS: Our study suggests that LMCA rotational atherectomy and stenting are safe and effective revascularization procedures in high-risk patients and patients who are not candidates for bypass surgery.|*Atherectomy, Coronary[MESH]|*Stents[MESH]|Aged[MESH]|Coronary Disease/surgery/*therapy[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH] |
