Revascularization of Unprotected Left Main Lesions in Octogenarians

Two-year results of a case-series study suggest that PCI might be a viable alternative to CABG, but only in carefully selected patients.

Surgery is the standard treatment for left main coronary artery disease (LMCAD), but surgical risk increases with age. To explore the relative effectiveness of percutaneous coronary intervention versus coronary artery bypass grafting in older patients, these investigators retrospectively compared outcomes of both procedures in all octogenarians with LMCAD undergoing revascularization at one institution in Quebec. Between 2002 and 2008, 249 patients underwent either CABG (58%) or PCI (42%). The PCI group included patients who were not candidates for surgery (27%), who refused surgery (13%), and who had high-risk characteristics. Thus, on average, the PCI patients were older than the CABG patients and had lower ejection fractions, higher crea…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)