title: [Profil and course of complete obstruction of 3 coronary trunks].
abstract: In a series of 4000 patients subjected to coronary arteriography, 12 were found to have complete obstruction of three major coronary arteries, an incidence of 0.3 p. 100. The clinical manifestations did not follow a typical pattern. Although 9 had a previous myocardial infarction or heart failure, only 6 were incapacitated by angina or dyspnea. Except for one patient, the resting EKG was abnormal. Half had a markedly elevated resting end-diastolic pressure and gross abnormalities of left ventricular contraction. In spite of surgery in 7, with only one operative death, a yearly mortality rate of 20 p. 100 has been recorded during a 3-year follow-up. This extremely low survival rate, the severe functional impairment in half of the survivors, and the subsequent high yearly mortality rate, all suggest that surgery be considered before complete obstruction occurs in patients with significant disease of three coronary arteries. A 10 p. 100 yearly mortality rate reported in patients with triple vessel obstructions, also favours surgery in such patients with the hope of prolonging life, providing good distal runoff and satisfactory left ventricular contraction are present.
mesh_terms: D000328:Adult; D002302:Cardiac Output; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality
vernacular_title: Profil et évolution de l'obstruction compléte des trois troncs coronariens