title: Surgery for chronic total occlusion of the left main stem: a 10-year experience.
abstract: Chronic total occlusion of the left main stem coronary artery is rare. This retrospective study was conducted to evaluate outcomes of coronary artery bypass grafting between June 1998 and June 2008 in patients with chronic left main stem total occlusion. There were 17 (0.025%) cases detected in 67,082 coronary angiograms. The 14 men and 3 women had a mean age of 55.32 +/- 9.2 years. Risk factors included diabetes in 8, hypertension in 6, and smoking in 6. Of 54 grafts applied, 15 were arterial and 39 were venous; 14 patients had 3-vessel disease, and 3 had 4-vessel disease. Three patients required intraaortic balloon counterpulsation perioperatively. The mean intensive care unit stay was 2.1 +/- 1.2 days, and hospital stay was 7.1 +/- 1.5 days. Postoperatively, one patient suffered myocardial infarction, another had a transient ischemic attack with spontaneous recovery, and 2 developed atrial fibrillation. There was no operative or hospital death. Surgical revascularization is considered appropriate treatment for chronic total occlusion of the left main stem.
authors.affiliation: Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore, Pakistan. rajapakhtar@gmail.com
authors.forename: Raja Parvez
authors.initials: RP
authors.lastname: Akhtar
authors.forename: Mumraiz Salik
authors.initials: MS
authors.lastname: Naqshband
authors.forename: Abdul Rehman
authors.initials: AR
authors.lastname: Abid
authors.forename: Zafar
authors.initials: Z
authors.lastname: Tufail
authors.forename: Abdul
authors.initials: A
authors.lastname: Waheed
authors.forename: Jawad Sajid
authors.initials: JS
authors.lastname: Khan
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D002908:Chronic Disease; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping; D002546:Ischemic Attack, Transient / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome