PERCUTANEOUS IMPLANTATION OF CORONARY STENTS FOR LESION OF THE LEFT MAIN CORONARY-ARTERY

Left main coronary artery (LM) stenting has only been reported in bail -out situations or absolute contraindications so surgery. The authors report the immediate and midterm results of primary Palmaz-Schatz sten t implantation in two young patients without contraindication to surge ry. The first patient, 58 year-old, was admitted for unstable angina i n October 1994. Coronary angiography showed an isolated severe ostial lesion of the LM. After conferring with the surgical team which remain ed on stand-by, angioplasty and stent implantation were performed with excellent results, no complications and no restenosis on angiographic controls at 3 and 12 months. The patient remained asymptomatic 24 mon ths later. The second patient, 38 year-old, was admitted in June 1995 for unstable angina, and coronary angiography showed a severe isolated stenosis in the middle of a long and wide LM. Primary coronary stenti ng was also performed with excellent results, no complication and no r estenosis on angiographic controls at 4 and 8 months. This patient was still asymptomatic 16 months after stenting. These excellent immediat e and medium-term results are encouraging and suggest that this form o f treatment might be extended to patients with an isolated whether pri mary LM stent implantation could become a suitable alternative to surg ery in the future.