title: [Surgical revascularization in stenosis and occlusion of the left main coronary artery].
abstract: From 1975 through 1981 130 patients underwent coronary revascularization for significant stenosis or complete occlusion of the left main coronary artery (LMA). Hospital mortality was 4.6%, 3.3% were related to cardiac causes. The incidence of perioperative infarcts was 9.7%; in three fourths of these patients cardiovascular complications (e.g. hypertension, hypotension, arrhythmias) had occurred between start of anesthesia and start of extracorporeal circulation. Patients with a more than 90% LMA stenosis and complete occlusion of the right coronary artery appear to be at a particularly high risk both in terms of mortality and perioperative infarcts as compared to all other LMA-stenosis patients (operative mortality 15% vs. 3.5%, perioperative infarcts 15% vs. 8.8%). 3 patients with complete LMA occlusion did not suffer perioperative infarcts and survived in the long term. Follow-up investigation (mean 28.8 months) revealed late infarcts in 9 patients, 5 of which were lethal (late mortality 4.1%). Of hospital survivors, 88% were entirely asymptomatic or had very little angina pectoris (classes I and II NYHA). Cumulative survival was 84.3% at 5 years.
mesh_terms: D000787:Angina Pectoris / Q000209:etiology; D003327:Coronary Disease / Q000601:surgery*; D005112:Extracorporeal Circulation; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000401:mortality; D011183:Postoperative Complications; D012306:Risk
vernacular_title: Operative Revaskularisation bei Stenose und Verschluss des linken Koronarhauptstammes.