Document Detail


Left main coronary angioplasty in surgical and nonsurgical candidates: putative role for a preconditioned expert culture on clinical outcome.
MedLine Citation:
PMID:  18340190     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The impact of patient- and operator-related clinical variables of success and evaluation of subsequent midterm effects of percutaneous treatment of left main coronary stenosis were assessed at a tertiary-referral high-volume angioplasty center in a retrospective observational study. A total of 118 consecutive surgical and nonsurgical patients with protected and unprotected left main (LM) lesions were treated by operators within a preconditioned expert culture. There were 57 protected and 61 unprotected patients, including 13 patients with an acute myocardial infarction (AMI). Mean age was 67 years (range 33-90). The length of the stenotic segment was 4.8 +/- 2.3 mm, mean lumen diameter was 1.1 +/- 0.6 mm, and percentage diameter stenosis was 63.6 +/- 14.6%. There were 7 (5.9%) in-hospital cardiac deaths that presented with AMI and cardiogenic shock. All 7 patients presented with unprotected LM lesions. Average follow-up was 8 months (range 1-36 months). Major adverse cardiac events (MACE) during follow-up comprised 8 (6.8%) cardiac deaths, 3 (2.5%) myocardial infarctions, 8 (6.8%) subjects with coronary bypass surgery, and 16 (13.6%) repeated angioplasties. The total event rate (MACE, n = 43) at the end of the follow-up period was 36.4%. There were more MACE in the unprotected group than in the protected group (41% vs. 31.6%, P<0.05). This study supports prior data on LM angioplasty. LM stenting in AMI showed less favorable in-hospital and late outcome.
Authors:
Johannes O J Peels; Willem-Peter T Ruifrok; Gillian A J Jessurun; Raymond W M Hautvast; Ad J van Boven; Felix Zijlstra; Rene A Tio
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  4     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2008-03-14     Completed Date:  2009-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  88-97     Citation Subset:  -    
Affiliation:
Department of Cardiology, Medical Centre, Alkmaar, The Netherlands.
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