TY - JOUR
T1 - A Practical Approach to Left Main Coronary Artery Disease
T2 - JACC State-of-the-Art Review
AU - Davidson, Laura J.
AU - Cleveland, Joseph C.
AU - Welt, Frederick G.
AU - Anwaruddin, Saif
AU - Bonow, Robert O.
AU - Firstenberg, Michael S.
AU - Gaudino, Mario F.
AU - Gersh, Bernard J.
AU - Grubb, Kendra J.
AU - Kirtane, Ajay J.
AU - Tamis-Holland, Jacqueline E.
AU - Truesdell, Alexander G.
AU - Windecker, Stephan
AU - Taha, Roza A.
AU - Malaisrie, S. Chris
N1 - Publisher Copyright:
© 2022
PY - 2022/11/29
Y1 - 2022/11/29
N2 - The treatment of left main (LM) coronary artery disease (CAD) requires complex decision-making. Recent clinical practice guidelines provide clinicians with guidance; however, decisions regarding treatment for individual patients can still be difficult. The American College of Cardiology's Cardiac Surgery Team and Interventional Council joined together to develop a practical approach to the treatment of LM CAD, taking into account randomized clinical trial, meta-analyses, and clinical practice guidelines. The various presentations of LM CAD based on anatomy and physiology are presented. Recognizing the complexity of LM CAD, which rarely presents isolated and is often in combination with multivessel disease, a treatment algorithm with medical therapy alone or in conjunction with percutaneous coronary intervention or coronary artery bypass grafting is proposed. A heart team approach is recommended that accounts for clinical, procedural, operator, and institutional factors, and features shared decision-making that meets the needs and preferences of each patient and their specific clinical situation.
AB - The treatment of left main (LM) coronary artery disease (CAD) requires complex decision-making. Recent clinical practice guidelines provide clinicians with guidance; however, decisions regarding treatment for individual patients can still be difficult. The American College of Cardiology's Cardiac Surgery Team and Interventional Council joined together to develop a practical approach to the treatment of LM CAD, taking into account randomized clinical trial, meta-analyses, and clinical practice guidelines. The various presentations of LM CAD based on anatomy and physiology are presented. Recognizing the complexity of LM CAD, which rarely presents isolated and is often in combination with multivessel disease, a treatment algorithm with medical therapy alone or in conjunction with percutaneous coronary intervention or coronary artery bypass grafting is proposed. A heart team approach is recommended that accounts for clinical, procedural, operator, and institutional factors, and features shared decision-making that meets the needs and preferences of each patient and their specific clinical situation.
KW - coronary artery bypass grafting
KW - coronary artery disease
KW - left main coronary artery disease
KW - myocardial revascularization
KW - percutaneous coronary intervention
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U2 - 10.1016/j.jacc.2022.09.034
DO - 10.1016/j.jacc.2022.09.034
M3 - Review article
C2 - 36423996
AN - SCOPUS:85141789578
SN - 0735-1097
VL - 80
SP - 2119
EP - 2134
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 22
ER -