Climbing the hill of left main coronary artery revascularization: percutaneous coronary intervention or coronary artery bypass graft?

Unprotected left main coronary artery (ULMCA) disease can be found in 3–10% of patients undergoing coronary angiography and has an impact on prognosis (1). Surgical myocardial revascularization by means of coronary artery bypass graft (CABG) has traditionally represented the standard therapeutic procedure for ULMCA disease (2) mainly because up to 80% of left main (LM) lesions involve the bifurcation and up to 80% of patients with ULMCA disease also have multivessel coronary artery disease.