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David Taggart
David Taggart is currently Professor of Cardiovascular Surgery at the University of Oxford (2004-) and a Consultant Cardiac Surgeon at the John Radcliffe Hospital (1995-) in Oxford. He qualified from Glasgow University in 1981 and pursued his basic surgical training in Glasgow. In 1989 he was awarded an MD with Honours and he was subsequently appointed the Senior Registrar at the Royal Brompton Hospital under Professor Yacoub and Mr Lincoln (1992-5).

His main interests are coronary revascularization, arterial grafts and off pump surgery. He has authored around 120 peerreviewed scientific papers and is the co-editor in chief of the Journal of Cardiothoracic Surgery.
Management of left main coronary artery disease: CABG is still the best therapy

David P. Taggart
John Radcliffe Hospital, Oxford, UK

Address for correspondence:
Dr David P. Taggart
Professor of Cardiovascular Surgery, University of Oxford
Dept of Cardiac Surgery, John Radcliffe Hospital
Oxford, OX3 9DU, UK
Tel: +44-(0)1865-221121 Fax: +44-(0)1865-220244
Email: david.taggart@btinternet.com

Abstract
This article reviews the pathophysiology of left main stem stenosis and the rationale for coronary artery bypass graft (CABG) surgery and stenting. As the majority of left main stem stenoses are distal/bifurcation lesions (at very high risk of restenosis with stents) and the majority of patients also have multivessel coronary artery disease (for which CABG is already a superior therapy to stents), the result is that for most unprotected left main stem stenosis surgery remains the standard of care. In the absence of real clinical equipoise, the article questions the ethics of randomised trials for left main stem stenosis and strongly advocates that all patients requiring intervention should receive advice from a multidisciplinary team.