Left main coronary artery stenosis: cardiologist view

Authors: O.L. Barbarash 1, O.M. Polikutina 1, E.V. Tavlueva 1, N.A. Barbarash 2

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Sciences; Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
2Kemerovo State Medical Academy of Ministry of Health of the Russian Federation; ulitsa Voroshilova, 22a, Kemerovo, 650029, Russian Federation

Type:  Stable ischemic heart disease

DOI: https://doi.org/10.15275/kreatkard.2015.02.01

For citation: O.L. Barbarash, O.M. Polikutina, E.V. Tavlueva, N.A. BarbarashLeft main coronary artery stenosis: cardiologist viewCreative Cardiology. 2015; 2: 5-15

Keywords: stenosis of the left coronary artery myocardial revascularization fractional flow reserve multivessel coronary disease

Full text:  



The degree of damage of the left main coronary artery (LM) is one of the main factors determining survival in patients with coronary artery disease (CAD). Both anatomy and atherosclerotic lesions of LM are described in the article. The LM stenosis of more than 50% allows to refer the patients to the category of a high risk of a sudden death. The review presents a detailed description of the clinical and functional characteristics of a patient with LM stenosis. Currently there are number of studies revealing the complexity of invasive coronary angiography in assessment the degree of LM lesion. From that point of view “the gold standard” of invasive assessment of myocardial ischemia in patients with LM stenosis is measuring of fractional flow reserve. Intravascular ultrasound significantly helps to assess a degree of arteries stenosis, a nature of plaque, a proper diameter of the vessel and an adequacy of stenting. The review presents the management options in patients with LM stenosis. It is considered that survival rate different enormously in patients with medical or surgical strategy. According to the latest European guidelines, choosing the revascularization technique requires a Heart Team discussion to define the best revascularization strategy in relation of efficiency and safety.


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About Authors

  • Barbarash Ol’ga Leonidovna, MD, DM, Professor, Director of Research Institute for Complex Issues of Cardiovascular Diseases Siberian Branch of the Russian Academy of Sciences, Chief of Laboratory;
  • Polikutina Ol’ga Mikhaylovna, MD, PhD, Chief of Laboratory;
  • Tavlueva Evgeniya Valer’evna, MD, DM, Leading Research Associate
  • Barbarash Nina Alekseevna, MD, DM, Professor

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery