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Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a randomized, controlled trial. Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Prognostic implications of baseline 6‐min walk test performance in intermediate risk patients undergoing transcatheter aortic valve replacement Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From EMPEROR-Reduced The conductive function of biopolymer corrects myocardial scar conduction blockage and resynchronizes contraction to prevent heart failure Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion

Review Article2018 Mar 23;20(5):29.

JOURNAL:Curr Cardiol Rep. Article Link

Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention

Kanmanthareddy A, Anugula D, Kar B. Keywords: Hemodynamic support; High-risk intervention; Left main; Operator experience; Percutaneous coronary intervention

ABSTRACT


PURPOSE OF REVIEWThis review was performed with the goal of summarizing the role of operator experience in the treatment of severe left main stenosis by percutaneous intervention techniques.


RECENT FINDINGS - The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial demonstrated that percutaneous coronary intervention and coronary artery bypass grafting had similar clinical outcomes for severe left main disease. However, PCI of the left main coronary stenosis is considered to be a high-risk intervention because of the large area of myocardium at jeopardy that can quickly cause hemodynamic compromise. Operator experience and familiarity with the use of hemodynamic support devices, plaque modification techniques, and intravascular imaging tools is associated with better clinical outcomes. In patients with severe left main stenosis undergoing percutaneous coronary intervention by high-volume operators, the clinical outcomes are superior.