Current Best Evidence for the Treatment of Left Main Trunk Disease

A Cardiac Surgeon's Perspective

Abstract

From the standpoint of a cardiac surgeon, the best evidence for the treatment of stable left main trunk disease is a 3.1% reduction in 5-year all-cause mortality with coronary artery bypass grafting (CABG). The question is how this 3.1% reduction in 5-year all-cause mortality by choosing CABG should be viewed (i.e. clinically significant or clinically insignificant). The magnitude of the survival benefit of CABG with internal thoracic artery graft increases with time over decades. Therefore, my opinion is that the strategy of choosing CABG may be appropriate at a younger age with a longer life expectancy.