Left main coronary artery disease (LMCAD) has a low incidence but foreshadows a high prognostic risk merely due to the myocardial territory it supplies. Coronary artery bypass grafting (CABG) has been the standard of treatment for LMCAD. Recently, two major trials—NOBEL and EXCEL—with contradicting results have been published.
I will not wade into the accusations of malfeasance, but the bottom line is that the superiority of percutaneous coronary interventions (PCI) to CABG is yet to be proved. Heart-team approach has been discussed in every aspect, but in real-world scenarios, to what extent, and in what manner the same is practiced, remains a question. We need an objective type of heart-team approach than a subjective heart-team approach.
