Response to Letter Regarding Article, 'Outcomes in Patients With De Novo Left Main Disease Treated With Either Percutaneous Coronary Intervention Using Paclitaxel-Eluting Stents or Coronary Artery Bypass Graft Treatment in the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) Trial'

We thank Dr Uretsky for his interest in our study.1 He is correct that 248 of 705 patients who were visually assessed as having distal left main (LM) bifurcation disease by the site's Heart Team (interventional cardiologist, cardiothoracic surgeon, and study coordinator) were later determined by the core laboratory to not strictly meet the study protocol definition of LM disease (eg, the patients were determined to have B- [Medina type 0,1,0]- or E- [Medina type 0,0,1]-type distal LM bifurcation lesions). This discrepancy between the site and core laboratory determinations is typical of clinical trials that use a …