Elderly man of 87 y.o. is hospitalized for chest pain and negative T waves on ECG. Positive troponin. After medical treatment, the patient was still symptomatic but with good hemodynamic parameters. I performed a coronary angiography at 2 hours after hospitalization, and found a left main proximal stenosis of 90%. Syntax score 7, CRUSADE moderate (36), GRACE high. After wiring the LAD and CX, with an additional BMW in the aorta, pre-dilatation was performed with a 4 mm balloon. A short 4 mm stent was implanted, post-dilated with a short noncompliant balloon of 5mm. Would you have treated otherwise?
How would you treat this left main?
