Left coronary artery system source diseases. Surgical issues.
The "source" area (LCS) of the LCA is defined as the extent of LCA proximally from the aortic ostial origin to distally upto the origin of the first septal perforator (Spl) of left anterior descending (LAD) and the origin of the first obtuse marginal branch (OM1) of the circumflex artery (Cx). This LCS is divided in 3 segments: (A) The most proximal segment extending from aortic ostium to first 5 mm of left main (LM) artery. (B) From the end of segment A to bifurcation of LM. (C) From bifurcation to proximal LAD till the origin of Spl combined with proximal Cx till the origin of OM1. Significant disease is defined as 50% or more stenosis of segments A or B or combined stenoses of 70% or greater in both LAD and Cx in segment C. From March 1985 through December 1987, out of 758 consecutive coronary artery procedures (CABG) (731 isolated CABGs), 179 patients were identified to have LCS disease. Ninety-seven (54.19%) patients had at least one myocardial infarction (MI) before. Twenty-eight (15.64%) patients underwent urgent or emergency operations. LV angiogram was not done in 10 and ejection fraction was less than 40% in 24 other patients. Age group ranged 40-74 years including 31 septuagenarians. Preoperative lysis was attempted in 7 and PTCA in 4 patients. Two-vessel-CAD was present in 26 (14.53%) patients, 3-vessel-CAD in 153 (85.47%) patients. Associated distal CAD was seen in LAD system in 134 (74.86%), in Cx system in 104 (58.1%) and in RCA system in 153 (85.47%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Ghosh
P K
PK
Herzchirurgie Salzburg, Landeskrankenanstalten Salzburg, Austria.
Antretter
H
H
D000368:Aged; D001317:Austria / Q000453:epidemiology; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000401:mortality; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies