Interventional Treatment Of Unprotecte Left Main Coronary Artery Of Clinical Efficacy Observation

Objective:The purpose of the present report was to retrospectively analyze the incidencerate of major adverse cardiac even(MACE),including death,myocardial infarction andtarget lesion reconstruction of783patients with unprotect left main coronary artery（ULMCA）after the percutaueous coronary intervention (PCI) treatment in theCardiology Department of People’s Hospital of Jiangxi province between January2001to January2011，and to assess the validity and safety for patients with ULMCA.Methods:Between January2001and January2011,the patients diagnosed by coronaryartery angiography(CAG) and treated with percutaneous coronary intervention (PCI)treatment in the Cardiology Department of People’s Hospital of Jiangxi provincewere analyzed retrospectively.According to lesions characteristics,the patients weredivided into different groups:bifurcation lesions group（217/783) and non-bifurcationlesions group(566/783).The Syntax score was used on every patient,recording theincidence rate of MACE during period of in-hospital and follow-up(includingtelephone,out-patient and hospital review).Results:1、PCI: Among783patients, all of them with ULMCA disease underwentcomplete revascularization(CR),and the overall success rates of patients and lesionsin this chort were100%(783/783).The left main coronary artery group were alltreated with single stent technique,whereas552patients with double stent techniquein the bifurcation lesions group. No one died in operation,with fewercomplications,postoperative hospitalization without cardiovascular events.2、Follow-up:Most of the clinical baseline conditions were similar between bothgroups.716(91.4%)patients completed follow-up and review coronary angiographywith a duration of (28.5±16.9)months. The total occurrence of death including24high SYNTAX scores patients, MACE, myocardial infarction, target lesionrevascularization(TLR) were25(3.2%),83(10.6%),15(2.1%), and43(5.5%) respectively. Compared with non-bifurcation,patients with the bifurcation were morelikely to have higher MACE rate(6.0%vs.12.4%, P=0.009),and the average TLR ofthe Culotte group was lower than that of the Crush group(4.0%vs.10.6%, P=0.005).As for the MACE rate,the average SYNTAX score of the low-risk group was lowerthan that of the high-risk group.(8.7%vs.17.0%,P=0.041).Conclusions:1、PCI treatment for ULMCA is safe and feasible.2、The MACE rate of the left main coronary bifurcation group was higher thanthe left main coronary non-bifurcation group.3、The average TLR of the Culotte group was lower than that of the Crushgroup.4、The SYNTAX score of the high-risk group were more likely to have thehigher MACE rate than that of the low-risk group.5、 Popularizing intervention treatment for ULMA is feasible in theCABG backward area. Preoperative careful analysis of clinical and pathologicalcharacteristics of the choice of the surgical strategy is a must and having a goodmaster is the guarantee of a successful operation...