Download PDF by Tamburino C. : Left Main Coronary Artery Disease

By Tamburino C.

ISBN-10: 8847014298

ISBN-13: 9788847014299

ISBN-10: 8847014301

ISBN-13: 9788847014305

Fresh advancements within the box of percutaneous coronary intervention and inspiring facts in relation to feasibility and protection have ended in a renewed curiosity in left major angioplasty. Interventional cardiologists are confronted with the problem represented through this complicated subset of lesions. the 1st a part of this useful instruction manual particularly bargains with the advance of the anatomical class and offers an summary of the frequency of other anatomic phenotypes. the second one half presents a complete wisdom at the ideas and method of left major coronary artery affliction and talk about the aptitude problems. The authors draw on their useful adventure to examine anticipated or power morbidity from percutaneous coronary intervention. the purpose of this booklet is to supply interventional cardiologists with necessary suggestions and tips for percutaneous coronary intervention of the left major coronary artery.

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8 mm and a minimum lumen area 30 a 3 Morpho-functional Assessment of Left Main Coronary Artery Disease b c Fig. 2 Left main coronary artery with a suspected ulcerated plaque (arrows) in caudal posterioranterior (a) and caudal left anterior oblique views (b). IVUS image confirms the presence of plaque ulceration (red points) without significant stenosis (c) (MLA) of <6 mm2. This parameter is the result of Murray’s law [88] and of a study by Jasti et al. who correlated IVUS with the FFR [89]. The application of these parameters makes it possible to identify critical lesions with a high degree of accuracy and to exclude angiographic false positives.

A MACE rate of 33% (cardiac death 15% and myocardial infarction 4%) and definite ST rate of 3% were recorded, in a total of 27 patients at long-term follow-up (median 28 months) [81]. Finally, in a series of 11 patients with clinically significant de novo left main coronary artery trifurcation lesion, Tamburino et al. observed a 27% incidence of TLR and 9% incidence of cardiac death, at 24 months of mean follow-up [82]. Overall, these results are consistent in showing that stenting of this subset of high-risk lesions is feasible and is associated with an acceptable incidence of TLR and favorable safety results, considering the complexity of lesions and patients treated..

6 Three-dimensional Quantitative Coronary Analysis Reconstruction of the Left Main Coronary Artery 39 b Fig. ) Severe distal LMCA stenosis involving the LAD and LCX. 7 The Role of Multi-slice Computed Tomography In recent years MSCT has seen rapid technological development, which has allowed this technique to establish itself as a possible non-invasive alternative to conventional coronary angiography in diagnosing atherosclerotic coronary artery disease [113]. Latest-generation 64-slice scanners have dramatically improved the diagnostic performance of coronary computed tomographic angiography (CCTA) compared to previous 16-slice versions, and continual improvements are being made in reducing the still significantly high doses of radiation [114].

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Left Main Coronary Artery Disease by Tamburino C.


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