Emergency intervention for unprotected left main coronary artery stenosis: case report and review of the literature.
Left main coronary artery stenosis is an important cause of symptomatic coronary artery disease, although relatively infrequent. The current guidelines recommend coronary artery bypass grafting as the first line treatment and standard of care, but percutaneous coronary intervention is likely to lead to faster reperfusion of coronary flow, avoiding the delays of a major surgical intervention. Our patient overcame cardiogenic shock after the flow of the left main coronary artery was rapidly restored through percutaneous coronary intervention and 6 days later, when hemodynamically stable, he underwent elective coronary artery bypass graft surgery. One year after the intervention, the patient has a normal functional status and an ejection fraction of 52%. This result is compatible with several small studies showing that percutaneous coronary intervention in left main coronary artery occlusions is feasible and effective, with a good short- and mid-term prognosis.