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High-Sensitivity Troponin and The Application of Risk Stratification Thresholds in Patients with Suspected Acute Coronary Syndrome Multivessel PCI Guided by FFR or Angiography for Myocardial Infarction Deficiency of GATA3-Positive Macrophages Improves Cardiac Function Following Myocardial Infarction or Pressure Overload Hypertrophy Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction Optimal medical therapy vs. coronary revascularization for patients presenting with chronic total occlusion: A meta-analysis of randomized controlled trials and propensity score adjusted studies Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial The year in cardiovascular medicine 2020: acute coronary syndromes and intensive cardiac care Clinical and genetic characteristics of pulmonary arterial hypertension in Lebanon Imaging Coronary Anatomy and Reducing Myocardial Infarction 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures

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.