title: Classification of left main coronary obstruction--feasibility of surgical angioplasty and survival after coronary artery bypass surgery.
abstract: Angiographies of 384 patients who had coronary artery bypass surgery because of left main coronary artery (LMCA) obstruction during 1970-1989 were reviewed by analysing the pathology, feasibility of surgical angioplasty and survival. Complete LMCA occlusion was found in 2%, proximal ostial stenosis in 9%, mid-shaft stenosis in 24%, circular stenosis in 25% and distal bifurcation stenosis in 40% of the patients. Patients with an ostial stenosis were younger, more often women with less coronary artery disease and less calcified obstructions. Surgical angioplasty could have been an option in 22% of the patients. Early mortality was higher in patients with (4.7%) than in those without (1.9%) LMCA obstruction. The relative risk (RR) of early death was 1.9 (95% CL 1.1-3.5) after adjustment for patient characteristics. Similarly, the RR at 10 years was 1.3 (95% CL 1.0-1.6). LMCA obstruction was associated with an early and long-term increased mortality after surgery compared to patients without LMCA obstruction.
authors: Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden. anders.jonsson@ks.se
authors: A
authors: A
authors: Jönsson
authors: T
authors: T
authors: Ivert
authors: B
authors: B
authors: Svane
authors: J
authors: J
authors: Liska
authors: K
authors: K
authors: Jakobsson
authors: N
authors: N
authors: Hammar
mesh_terms: D000367:Age Factors; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D023921:Coronary Stenosis / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016896:Treatment Outcome