Remarkable advances in the management of coronary artery disease have enhanced our approach to left main coronary artery (LMCA) disease. The traditional role of coronary artery bypass graft surgery has been challenged by the less invasive percutaneous coronary interventional approach. Additionally, major strides in optimal medical therapy now provide a rich menu of treatment choices in selected circumstances. Although a LMCA stenosis >70% is an acceptable threshold for revascularization, those patients with a LMCA narrowing between 40 and 69% present a more complex scenario. This review examines the relative merits of the different treatment options, addresses key diagnostic and therapeutic unknowns, and identifies future work likely to advance progress.

中文翻译：

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左主干冠状动脉疾病：不断发展的管理理念

冠状动脉疾病管理的显着进步增强了我们治疗左主干冠状动脉 (LMCA) 疾病的方法。冠状动脉旁路移植手术的传统作用受到侵入性较小的经皮冠状动脉介入治疗方法的挑战。此外，最佳药物治疗的重大进展现在在选定的情况下提供了丰富的治疗选择菜单。尽管 LMCA 狭窄＞70% 是血运重建的可接受阈值，但 LMCA 狭窄在 40% 和 69% 之间的那些患者呈现出更复杂的情况。这篇综述检查了不同治疗方案的相对优点，解决了关键的诊断和治疗未知数，并确定了可能推动进展的未来工作。