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Just accepted article

Physiological Assessment of Left Main Coronary Artery Disease

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1. King's College London, Cardiovascular Division, St Thomas' Hospital Campus, London, UNITED KINGDOM; 2. AMC Heartcenter, Academic Medical Centre, University of Amsterdam, Netherlands; 3. AMC Heartcenter, Academic Medical Centre, University of Amsterdam, Netherlands; 4. King's College London, London, UNITED KINGDOM

Abstract

The left main coronary artery (LMCA) is responsible for supplying the majority of the left ventricular myocardium. Visual estimation of stenosis severity on angiography has major limitations and methods to assess functional significance, such as Fractional Flow Reserve (FFR), have been shown to yield better outcomes but major trials examining the use of such physiological indices have excluded LMCA disease to date. Furthermore, LMCA disease commonly co-exists with downstream disease, which complicates interpretation of coronary physiological data. This review summarizes existing evidence for physiology-guided management of…

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