Since the first clinical description of left main coronary artery (LMCA) disease by Herrick in 1912, [1] numerous studies have shown that stenosis of the left main is of critical prognostic importance. LMCA disease poses special management problems due to the extensive myocardial territory at risk during the revascularisation procedure. Histological differences including the increased elastic tissue within the LMCA also makes their management different.Angiographically significant left main stenosis has been defined as diameter stenosis greater than 50%. The prevalence of significant LMCA disease in patients with coronary artery disease (CAD) varies from 2.5 to 10% in various published studies. [2,3] The mortality and morbidity of this condition depends on various factors including the severity of the LMCA stenosis, associated disease in the other coronaries including the RCA, left dominance and LV function.