{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:22:28Z","timestamp":1768522948730,"version":"3.49.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"41","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In October 2021, the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) jointly agreed to establish a Task Force (TF) to review recommendations of the 2018 ESC\/EACTS Guidelines on myocardial revascularization as they apply to patients with left main (LM) disease with low-to-intermediate SYNTAX score (0\u201332). This followed the withdrawal of support by the EACTS in 2019 for the recommendations about the management of LM disease of the previous guideline. The TF was asked to review all new relevant data since the 2018 guidelines including updated aggregated data from the four randomized trials comparing percutaneous coronary intervention (PCI) with drug-eluting stents vs. coronary artery bypass grafting (CABG) in patients with LM disease. This document represents a summary of the work of the TF; suggested updated recommendations for the choice of revascularization modality in patients undergoing myocardial revascularization for LM disease are included. In stable patients with an indication for revascularization for LM disease, with coronary anatomy suitable for both procedures and a low predicted surgical mortality, the TF concludes that both treatment options are clinically reasonable based on patient preference, available expertise, and local operator volumes. The suggested recommendations for revascularization with CABG are Class I, Level of Evidence A. The recommendations for PCI are Class IIa, Level of Evidence A. The TF recognized several important gaps in knowledge related to revascularization in patients with LM disease and recognizes that aggregated data from the four randomized trials were still only large enough to exclude large differences in mortality.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad476","type":"journal-article","created":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T16:42:26Z","timestamp":1693068146000},"page":"4310-4320","source":"Crossref","is-referenced-by-count":47,"title":["2022 Joint ESC\/EACTS review of the 2018 guideline recommendations on the revascularization of left main coronary artery disease in patients at low surgical risk and anatomy suitable for PCI or CABG"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5224-6393","authenticated-orcid":false,"given":"Robert A","family":"Byrne","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network , 73 Eccles St, Dublin D07 KWR1 , Ireland"},{"name":"School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences , 123 St Stephen's Green, D02 YN77 Dublin, Ireland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1723-3049","authenticated-orcid":false,"given":"Stephen","family":"Fremes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Schulich Heart Program, Sunnybrook Health Sciences Centre , 2075 Bayview Ave, Suite H405, M4N3M5 Toronto , Canada"},{"name":"Department of Surgery, University of Toronto , Toronto , Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-7723","authenticated-orcid":false,"given":"Davide","family":"Capodanno","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular and Transplant Department, Azienda Ospedaliero-Universitaria Policlinico \u2018Gaspare Rodolico\u2014San Marco\u2019, University of Catania , Catania , Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-9775","authenticated-orcid":false,"given":"Martin","family":"Czerny","sequence":"additional","affiliation":[{"name":"Clinic for Cardiovascular Surgery, University Heart Center Freiburg , Bad Krozingen , Germany"},{"name":"Faculty of Medicine, Albert-Ludwigs-University Freiburg , Freiburg , Germany"}]},{"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Jena, Friedrich-Schiller-University Jena , Jena , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7792-9422","authenticated-orcid":false,"given":"Jonathan R","family":"Emberson","sequence":"additional","affiliation":[{"name":"Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford , Oxford , UK"}]},{"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin , Berlin , Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin , Germany"},{"name":"German Centre for Cardiovascular Research, DZHK, Partner Site Berlin , Berlin , Germany"},{"name":"Department of Health Science and Technology, ETH Zurich , Z\u00fcrich , Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4680-0815","authenticated-orcid":false,"given":"Mario","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine , New York, NY , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-3975","authenticated-orcid":false,"given":"John J V","family":"McMurray","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , Glasgow , UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5546-262X","authenticated-orcid":false,"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai , New York, NY , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-9011","authenticated-orcid":false,"given":"Milan","family":"Milojevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute , Belgrade , Serbia"},{"name":"Department of Cardiothoracic Surgery, Erasmus University Medical Center , Rotterdam , The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-653X","authenticated-orcid":false,"given":"Miguel","family":"Sousa Uva","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Santa Cruz , Carnaxide , Portugal"},{"name":"Department of Physiology and Cardiac Surgery, Porto University Medical School , Porto , 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