title: [Stenosis of the left main coronary artery. Results of aorto-coronary by-pass in 67 patients (author's transl)].
abstract: Between 1970 and 1978 sixty-seven patients with > 50% stenosis of the left main coronary artery underwent aorto-coronary by-pass operation. The mean follow-up period was 54.7 months. Early and late post-operative mortality rates amounted to 3% and 9.2% respectively. Severe global alteration of left cineventriculography was the primary factor of survival (p < 0.01). The actuarial survival rates were 90.3% at 5 years and 84.5% at 9 years. All survivors had control ECGs. Late myocardial necrosis was rare (0.6 per 100 patient-years). 60.3% of the patients remained free from angina. Deterioration of the results mainly occured during the first 2 years but continued at a slower pace beyond the 8th year. Recurrence of angina was significantly less frequent in patients with isolated left main stenosis (p < 0.05) and when local conditions were not unfavourable to derivative surgery (p. < 0.01). On the other hand, the patient's age, sex, type of angina, history of previous infarction, number of risk factors and number of by-passes (the latter excluding possibly incomplete revascularisation) has no influence on the functional prognosis. Thirty-two patients had control, usually routine coronary arteriography 13.7 months on average after surgery. Overall patency was found in 85.9% and abnormal grafts in 16.7% of the cases. The main benefits of aorto-coronary by-pass, therefore, were a reduction in the spontaneous mortality rate of patients with left main coronary disease and a pronounced functional improvement.
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis; D003251:Constriction, Pathologic; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011183:Postoperative Complications; D011379:Prognosis
vernacular_title: Sténose du tronc coronaire gauche: résultats des pontages aorto-coronaires chez 67 malades.