Left main coronary revascularization / / editor, Bernardo Cortese

• Record Nr.: UNINA9910768467703321
• Pubbl/distr/stampa: Cham, Switzerland : , : Springer, , [2022]; ©2022
• ISBN: 9783031052651; 9783031052644
• Descrizione fisica: 1 online resource (180 pages)
• Disciplina: 617.412
• Soggetti: Coronary artery bypass; Myocardial revascularization
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Nota di bibliografia: Includes bibliographical references.
• Nota di contenuto: Intro -- Foreword -- Preface -- References -- Contents -- 1: History of Left Main Revascularization -- 1.1 Introduction -- 1.2 The History of Left Main Stenosis -- 1.3 Overview of Early Trials in the Medical Management Era of LMCA Stenosis -- 1.4 Overview of Early Trials of Supporting CABG Superiority in LMCA Stenosis -- 1.5 Historical Background and Early Experience of LMCA PCI -- 1.6 Overview of Randomized Trials of LMCA PCI Using First Degeneration DES with/without BMS -- References -- 2: Historical Background of Left Main Stem Revascularization: A Step Further -- 2.1 Introduction of the Percutaneous Revascularization -- 2.2 The First-Generation DES Versus CABG for Unprotected LMCAD: Were Interventional Cardiologists Overconfident? -- 2.3 Tackling the Left Main Stem with the Second-Generation DES -- References -- 3: Anatomical and Pathophysiological Considerations on the Left Main Coronary Artery -- 3.1 Anatomy of the Left Main Coronary Artery -- 3.1.1 Normal Anatomy of the Left Main Coronary Artery -- 3.1.2 Anatomical Variations of the Left Main Coronary Artery -- 3.1.3 Histological Characteristics of the Left Main Coronary Artery -- 3.1.4 Normal Dimensions of the Left Main Coronary Artery -- 3.1.5 Anatomy of Distal Left Main Coronary Artery Bifurcation -- 3.2 Pathophysiology of the Left Main Coronary Artery -- 3.2.1 Prevalence of Left Main Coronary Artery Disease -- 3.2.2 Role ; of Endothelial Shear Stress in LM Bifurcation -- 3.2.3 Left Main Plaque Distribution -- 3.2.4 The Medina Classification for Left Main Bifurcation Disease -- 3.2.5 Uncommon Causes of Left Main Coronary Artery Disease -- References -- 4: CABG Vs. PCI for Left Main Revascularization -- 4.1 Introduction -- 4.2 Current Evidence Comparing PCI to CABG for LMCAD -- 4.2.1 Real-World Evidence -- 4.2.2 Randomized Clinical Trials.; 4.3 Guideline Recommendations on LMCAD Revascularization -- 4.4 Individualized Patient Approach -- 4.4.1 Predicted Surgical Risk -- 4.4.2 Anatomy of CAD -- 4.4.3 Completeness of Revascularization -- 4.4.4 Procedural Urgency -- 4.4.5 Clinical Characteristics -- 4.4.5.1 Diabetes Mellitus -- 4.4.5.2 Heart Failure with Reduced Ejection Fraction -- 4.4.5.3 Chronic Kidney Disease -- 4.4.5.4 Bleeding Risk -- 4.4.5.5 General Status of the Patient -- 4.5 Conclusions -- References -- 5: CABG Should Be the First Option for Left Main Disease: A Cardiac Surgeon's Perspective -- 5.1 Introduction -- 5.2 When PCI Is the Better Choice? -- 5.3 When Surgery Is the Better Choice? -- 5.4 Conclusions -- References -- 6: PCI Should Be the First Option for All Left Main Disease? An Interventional Cardiologist's Perspective -- 6.1 Introduction -- 6.2 Not all LMS Disease is the Same -- 6.3 The Evidence -- 6.4 Longer Term Outcomes PCI vs CABG -- 6.5 Limitations of Trials to Date -- 6.6 PCI Technique and Strategy -- 6.7 PCI in the Emergency Setting -- 6.8 Unanswered Questions -- 6.9 Conclusion -- References -- 7: Which Interventional Device for Left Main PCI? A Description of Available Stents -- 7.1 Introduction -- 7.1.1 Xience (Abbott Vascular, Santa Clara, CA, USA) -- 7.1.2 Xience Vs Synergy -- 7.1.3 Biomatrix ™ Stent -- 7.1.4 Resolute Onyx -- 7.1.5 Orsiro Sirolimus-Eluting Stent -- 7.1.6 Ultimaster™ Tansei™ Stent (Terumo Corporation, Tokyo, Japan) -- 7.1.7 Xposition S Sirolimus-Eluting Stent (Stentys, Paris, France) -- 7.1.8 Dedicated Bifurcation Stent -- 7.2 Conclusion -- References -- 8: Which Interventional Technique for Left Main PCI? -- 8.1 Introduction -- 8.2 What Is Special About the Left Main Stem? -- 8.3 Provisional Side Branch Stenting -- 8.4 Systematic Two-Stent Approach -- 8.5 Difficult Wire Access.; 8.6 Role of Intracoronary Imaging -- 8.7 Role of Stent Enhancement -- 8.8 Role of Mentorship -- 8.9 Tips and Tricks -- 8.10 Conclusion -- References -- 9: Which Surgical Technique for Left Main Coronary Artery Bypass? A Mini-Invasive Approach -- 9.1 Introduction and History -- 9.2 Indications -- 9.3 Contraindications -- 9.4 Surgical Procedure -- 9.5 Outcomes and Comparison to Other Revascularization Strategies -- 9.6 Hybrid Coronary Revascularization -- 9.6.1 Timing of the HCR -- 9.6.2 HCR Outcomes -- 9.7 Conclusions -- References -- 10: Preoperative IVUS Assessment of the Left Main -- 10.1 Introduction -- 10.2 Intravascular Ultrasound (IVUS) Technology -- 10.3 The Role of IVUS in Pre-operative LMCA Assessment -- 10.3.1 Plaque Morphology at IVUS -- 10.3.2 IVUS-Based Indication for Treatment and Relationship with Functional Evaluation -- 10.3.3 IVUS-Guided LMCA Assessment: Impact on Therapeutic Strategies -- 10.4 IVUS-Guided LMCA PCI: Clinical Evidences -- 10.5 Conclusions -- References -- 11: Preoperative Functional Assessment of the Left Main and Postoperative Side Branch Evaluation -- 11.1 Left Main Anatomy and Atherosclerotic Process -- 11.2 Limitations of the Angiography for LMS Evaluation -- 11.3 FFR and iFR: Principles -- 11.4 Tips and Tricks for LM Functional Assessment -- 11.5 Assessment of the Distal LM Bifurcation Post PCI -- 11.6 Conclusions -- References -- 12: Is There a Role for OCT for Left Main Assessment Before and After PCI? -- 12.1 Introduction -- ; 12.2 Left Main Stem Anatomy and Atherosclerotic Disease Distribution -- 12.3 Practical Tips and Tricks for Correct Assessment of Left Main by OCT -- 12.4 Use of OCT for the Definition of LM Disease and for the Assessment of Plaque Morphology -- 12.5 Use of OCT for the Guidance and Optimization of Left Main Bifurcation PCI -- 12.6 Conclusions -- References.; 13: A Clinical Appraisal of Optical Coherence Tomography for Left Main Stem Intervention -- 13.1 Introduction -- 13.2 Role of Intravascular Imaging to Improve Clinical Outcomes in Left Main Intervention -- 13.3 Assessment of Intermediate Lesions in the Left Main Stem -- 13.4 Clinical Data Supporting the Use of OCT Over IVUS -- 13.5 Ongoing Clinical Studies for LM PCI with OCT Guidance -- 13.6 Optimizing the Use of OCT in the LM with a Non-stent-Based Approach -- 13.7 Future Perspective -- References -- 14: The Role of Intravascular Imaging for Post-procedural and Long-Term Evaluation of the Revascularized Left Main -- References -- 15: Follow-up of Left Main Patients Treated with PCI or CABG -- 15.1 Background -- 15.2 Incidence and Time Course of Adverse Events After LMCA Revascularization -- 15.3 Dual Antiplatelet Therapy Duration -- 15.4 Role of Non-invasive and Invasive Ischemia Testing After LMCA PCI -- 15.4.1 Myocardial Perfusion Imaging -- 15.4.2 Exercise Stress Testing -- 15.4.3 Stress Echocardiography -- 15.4.4 Coronary Computed Tomography Angiography -- 15.4.5 Invasive Coronary Angiogram -- 15.5 Conclusion -- References.