OBJECTIVETo evaluate the safety and efficacy of drug-eluting stent (DES) implantation in selective patients with left main coronary artery disease.

METHODFrom October 2002 to November 2007, 44 consecutive patients underwent percutaneous coronary interventions (PCI) on left main coronary artery lesions, including 5 patients with concurrent left ventricular dysfunction (ejection fraction<40%), 2 with chronic respiratory dysfunction and 5 with chronic renal failure. The findings in coronary angiography, procedural success rate, severe complications and the follow-up results of the patients were analyzed.

RESULTSThe immediate procedural success rate was 100% in these patients without any severe complications. No non-fatal acute myocardial infarction or emergency coronary artery bypass grafting (CABG) was performed and death occurred in none of the cases during hospitalization. In the follow-up period for 14.2-/+9.3 (6-65) months after PCI, no subacute or late thromboses were found. One patient died from heart failure 4 months after PCI, and 6 patients (13.6%) experienced recurrent angina. Thirty-seven patients (84.1%) were free of any major cardiovascular events (MACE) after the procedure. A repeat coronary angiography was performed in 35 patients (79.5%) within 6 months after PCI, and 3 (8.6%) of them were confirmed to have restenosis, including 1 patient with distal bifurcation restenosis who were subsequently treated with CABG and two patients with side-branch ostium restenosis managed with cutting balloon dilation.

CONCLUSIONSImplantation of drug-eluting stents is safe and effective for management of left main coronary artery disease with good immediate and long-term outcomes.