Treatment of left main shock syndrome with percutaneous coronary intervention in the absence of an advanced left ventricular assist device or ECMO

Acute total occlusion of the unprotected left main coronary artery (LM) results in cardiogenic shock, or left main shock syndrome (LMSS), in the majority of affected patients (1). The prognosis of the subset of patients with LMSS and complete occlusion is dire, with up to 100% mortality (2). In this paper, three patients with LMSS who underwent percutaneous coronary intervention (PCI) alone or PCI with the implementation of IABP were included. We have discussed how to approach a patient with LMSS on diagnosis and transfer and its treatment in the absence of advanced LV assist devices or ECMO.