Tale of Two sons - Nobelar and Excelar and the blurring edge between them.

Left main coronary artery disease (LMCAD) has low incidence but foreshadow a high prognostic risk merely due to the myocardial territory it supplies. Coronary artery bypass grafting (CABG) has been the standard of treatment for LMCAD. Recently, two major trials-NOBEL and EXCEL-with contradicting results have been published. I will not wade into the accusations of malfeasance, but the bottom line is that, superiority of percutaneous coronary interventions (PCI) to CABG is yet to be proved. Heart-team approach has been discussed in every aspect, but in real-world scenario, to what extent, and in what manner the same is practised, remains a question. We need an objective type of heart-team approach than a subjective heart-team approach.