title: Plastic surgical reconstruction of left main coronary artery.
abstract: OBJECTIVE
  To report the early and mid-term results of surgical plasty of the left main coronary artery in 12 patients operated upon between 1993 and 1997.
  
  
  METHODS
  The anterior approach was used in all patients. Saphenous vein (n = 4) of glutaraldehyde treated autologous pericardium (n = 8) were used as patch material. Additional coronary artery bypass grafting was performed in 7 patients, the first 3 as a safety back up, and for coexisting stenosis of other coronary branches not revascularized by the plastic procedure in the remaining 4.
  
  
  RESULTS
  Pathologic specimens of the left main coronary artery in 5 revealed atheroma in 3 and myxomatous intimal thickening in 2. The left main coronary artery was widely patent angiographically in all patients prior to discharge. Six patients consented to angiographic restudy 5-40 months after the procedure and revealed excellent results in 5. One patient upon whom autologous pericardial patch had been used underwent percutaneous coronary angioplasty for restenosis of the left main coronary artery and a new lesion of the proximal left anterior descending branch 5 months after the operation. There were no late deaths nor other cardiac events. All patients were in CCS class 1 at their last follow-up.
  
  
  CONCLUSIONS
  Surgical angioplasty of the left main coronary artery could be used to revascularize the left heart safely in patients with a discrete localized lesion of the left main coronary artery and is particularly useful in the face of unavailability of other conduits.
authors.affiliation: Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Soga
authors.forename: H
authors.initials: H
authors.lastname: Okabayashi
authors.forename: I
authors.initials: I
authors.lastname: Shimada
authors.forename: S
authors.initials: S
authors.lastname: Enomoto
authors.forename: K
authors.initials: K
authors.lastname: Matsubayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Kamikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Saitoh
authors.forename: A
authors.initials: A
authors.lastname: Nagasawa
authors.forename: T
authors.initials: T
authors.lastname: Morimoto
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures