Percutaneous coronary intervention and coronary artery bypass surgery in patients with trunk disease

Abstract

It is important to know the evolution of patients with left main coronary artery disease after a percutaneous intervention or myocardial revascularization surgery. Objective: To describe the results of myocardial revascularization and percutaneous coronary intervention in patients with left main coronary artery disease in the "Hermanos Ameijeiras" hospital. Method: A comparative longitudinal descriptive observational research was conducted with retrospective data collected with a total of 138 patients; 41 patients with left main coronary artery disease who underwent percutaneous coronary intervention in the period of time 2010-2016 and 97 treated by coronary artery bypass grafting 2012-2016, in the Cardiology and Cardiovascular Surgery service of the  Cardiocentro of the Hermanos Ameijeiras Surgical Clinical Hospital. Results: Acute periprocedural myocardial infarction was more frequent in the presence of coronary artery bypass grafting (p = 0.028). Previous myocardial infarction and dyslipidemia were more frequent variables in percutaneous coronary intervention. The need for revascularization of the target vessel once a year was more frequent in patients treated by intervention (9.8%) compared to surgery (2.1%) (p = 0.043). Conclusions: The majority of patients treated with percutaneous coronary intervention presented less anatomical complexity and complications. Acute periprocedural myocardial infarction occurred more frequently in patients treated with coronary artery bypass grafting. The need for new revascularization was greater in patients treated by percutaneous intervention. There were no differences in overall survival
and patients were free of adverse events according to the type of revascularization procedure.