title: Patch angioplasty for isolated ostial stenosis of the left main coronary artery.
abstract: BACKGROUND
  Conventional coronary artery bypass grafting (CABG) is recognized as the treatment of choice for left main coronary artery stenosis (LMCA) with excellent results. Patch angioplasty is an alternative method in selected cases for ostial stenosis of the LMCA. However, the long-term outcome data of this surgical technique are lacking. Therefore, the aim of this study was to evaluate the long-term outcome of patients treated by patch angioplasty using saphenous vein for ostial stenosis of the LMCA.
  
  
  METHODS
  Nineteen patients underwent vein patch angioplasty for ostial LMCA stenosis between 1995 and 2005 at our institution. On three of them simultaneous aortic valve replacement was carried out and on one patient concomitant coronary artery bypass grafting of the right coronary artery was performed. Patients were followed up clinically and by magnetic resonance imaging (MRI) at 5.11 +/- 3.34 years (range 0.6-10 years).
  
  
  RESULTS
  The early postoperative course was uneventful in all patients. There were no in-hospital deaths. In the late course, three patients died from unrelated causes three and a half, four, and six years after surgery. Importantly, at the time of follow-up the MRI revealed no restenosis or aneurysmatic coronary formation. All patients were in excellent clinical condition at follow-up.
  
  
  CONCLUSIONS
  Surgical patch angioplasty with saphenous vein for isolated ostial LMCA stenosis is a safe operative technique with good long-term results. MRI is able to adequately depict the operative result of left main coronary ostium reconstruction.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St-Johannes Hospital Dortmund, Dortmund, Germany. botsios@arcor.de
authors.forename: Spiridon
authors.initials: S
authors.lastname: Botsios
authors.forename: Winfried
authors.initials: W
authors.lastname: Maatz
authors.forename: Udo
authors.initials: U
authors.lastname: Sprengel
authors.forename: Hubertus
authors.initials: H
authors.lastname: Heuer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Walterbusch
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000601:surgery*; D016896:Treatment Outcome